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目的探寻极低出生体重儿早期营养与体重、身长、头围的生长及远期神经运动发育的关系,为以后临床工作中对极低出生体重儿治疗护理提供帮助。方法在本院NICU住院的出生体重低于1 500g的新生儿86例,以出院时体重分为宫外生长迟缓(EUGR)、非EUGR组,出院后定期在高危儿随访门诊进行随访。定期测量体重,身长,头围,进行GMs质量评估,头颅MRI检查,发育商(DQ)评估。观察不同组别出院后体重、身长、头围的增长及运动、神经发育情况。结果 EUGR组纠正胎龄6、12月身长、头围均明显低于非EUGR组,差异有统计学意义(P<0.05)。纠正胎龄6月时EUGR组体重明显低于非EUGR组,差异有统计学意义(P<0.05),纠正胎龄12月时EUGR组体重与非EUGR组,差异无统计学意义(P>0.05),EUGR组GMs质量评估,头颅MRI检查阳性率均明显高于非EUGR组,差异有统计学意义(P<0.05)。两组发育商<85的比例差异无统计学意义(P>0.05),但EUGR组的平均发育商明显低于非EUGR组,差异有统计学意义(P<0.05)。极低出生体重儿EUGR组出院后体格、智能发育均明显低于非EUGR组。结论需重视极低出生体重儿生后营养管理,降低极低出生体重儿宫外生长迟缓的发生率。同时需注重极低出生体重儿出院后管理,关注出院后生长发育情况,加强营养指导,使EUGR出现明显的追赶性生长态势。
Objective To explore the relationship between early nutrition of very low birth weight children and the growth of body weight, length, head circumference and long-term neuromotor development, and to provide help for the treatment and care of very low birth weight children in clinical work. Methods Totally 86 newborns with NICOLI less than 1500g who were hospitalized in NICU of our hospital were divided into EUGR (non-EUGR group) and non-EUGR group at discharge. The patients were followed up at high-risk follow-up clinics regularly after discharge. Regular weight, length, head circumference, GMs quality assessment, head MRI examination, developmental providers (DQ) assessment. Observe the weight, body length, head circumference and exercise, neurological development in different groups after discharge. Results The body length and head circumference of EUGR group were significantly lower than those of non-EUGR group at 6 and 12 gestational weeks. The difference was statistically significant (P <0.05). The body weight of EUGR group was significantly lower than that of non-EUGR group at 6 months of gestational age (P <0.05), and there was no significant difference between EUGR group and non-EUGR group at 12 months (P> 0.05) ). The positive rates of GMs in the EUGR group and MRI in the head of the EUGR group were significantly higher than those in the non-EUGR group (P <0.05). There was no significant difference between the two groups (P> 0.05). However, the average developmental volume in EUGR group was significantly lower than that in non-EUGR group (P <0.05). EUGR group with very low birth weight had significantly lower physical and intellectual development than non-EUGR group after discharge. Conclusion We must pay attention to nutrition management of very low birth weight infants and reduce the incidence of extrauterine growth retardation of very low birth weight infants. At the same time, it is necessary to pay attention to the post-discharge management of very low birth weight children, pay attention to the growth and development after leaving the hospital, and strengthen the guidance of nutrition so that EUGR may have obvious catch-up growth.