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目的探讨深度水解蛋白配方奶(HPF)开奶与标准早产儿配方奶(SPF)相比,是否能减少极低出生体质量儿(VLBWI)喂养不耐受,使VLBWI更早达到全肠道喂养,促进VLBWI的生长发育。方法随机将2009年1-6月本院NICU收治的VLBWI 30例分为HPF组及SPF组,2组均以20 mL·kg-1.d-1开奶,并在能耐受的情况下按此速度加奶。HPF组在日龄14 d结束HPF喂养,换等量的SPF喂养;SPF组持续以SPF喂养。观察2组患儿开奶前7 d胃潴留总次数、第7天餐前胃残留奶量(包括最大胃残留量、全天胃残留总量/全天预计喂奶量)、体质量增长速度、达完全肠道喂养时间、28 d时体格发育情况及是否合并坏死性小肠结肠炎(NEC)。结果与SPF组相比,HPF组开奶前7 d胃残留总次数[(15.5±2.9)次vs(17.1±4.5次)]、第7天最大胃残留量[(0.9±1.0)mLvs(1.8±1.3)mL]、第7天全天胃残留量/全天预计奶量[(3.1±4.8)%vs(8.7±6.9)%]降低,胃排空改善,胃潴留量减少,达完全肠内喂养时间缩短[(12.7±4.2)dvs(16.6±4.8)d],平均每日体质量增长加快[(15.37±4.08)g·d-1vs(11.02±3.49)g.d-1],差异均有统计学意义(Pa<0.05)。2组患儿28 d时头围[(30.01±1.11)cmvs(29.05±1.20)cm]、身长[(42.85±1.62)cmvs(41.55±1.51)cm]、体质量[(1.792±0.213)kgvs(1.617±0.187)kg]比较,差异均有统计学意义(Pa<0.05)。2组患儿NEC发病率有明显差异。结论 HPF能够促进胃排空,改善VLBWI的喂养不耐受,并使其更早达到完全肠道内喂养,从而促进VLBWI的生长发育,可将HPF用于VLBWI的开奶。
Objective To investigate whether intolerance of VLBWI can be reduced compared with standard preterm infant formula (SPF) by deep-hydrolyzed protein formula (HPF) , Promote the growth and development of VLBWI. Methods 30 cases of VLBWI admitted to NICU from January to June in 2009 were randomly divided into HPF group and SPF group. Both groups were given 20 mL · kg-1.d-1 milk and were tolerated Add milk at this rate. The HPF group was fed HPF at the end of the 14th day of age and fed the same amount of SPF. The SPF group was fed with SPF continuously. The total number of gastric rehydration before 7 days and the residual amount of milk before meals (including the maximum residual gastric volume, the total residual gastric juice during the whole day / the estimated total amount of feeding during the whole day), the growth rate of body weight, Up to complete gut feeding, physical development at 28 days and whether necrotizing enterocolitis (NEC). Results Compared with the SPF group, the total number of gastric residues in the HPF group ([(15.5 ± 2.9) vs (17.1 ± 4.5) ± 1.3) mL]. The total amount of gastric residue on the 7th day / the estimated amount of milk during the whole day [(3.1 ± 4.8)% vs (8.7 ± 6.9)%] decreased gastric emptying and decreased gastric retention (12.7 ± 4.2) dvs (16.6 ± 4.8) d], and the average daily body weight gain accelerated [(15.37 ± 4.08) g · d-1vs (11.02 ± 3.49) gd-1] Statistical significance (Pa <0.05). The head circumference [(30.01 ± 1.11) cm vs (29.05 ± 1.20) cm], body length [(42.85 ± 1.62) cm vs (1.792 ± 0.213) cm vs 1.617 ± 0.187) kg], the difference was statistically significant (Pa <0.05). There was a significant difference in the incidence of NEC between the two groups. Conclusions HPF can promote gastric emptying, improve feeding intolerance of VLBWI and make it enter into full gut earlier, so as to promote the growth and development of VLBWI. HPF can be used for the opening of VLBWI.