早期肠内外营养对早产儿中小于胎龄儿宫外生长发育影响.doc

早期肠内外营养对早产儿中小于胎龄儿宫外生长发育影响 　　[摘要] 目的 探讨早期肠内联合肠外营养对早产儿中小于胎龄儿宫外生长发育情况的影响，为制定针对早产儿中小于胎龄儿的营养支持策略提供理论支持。 方法 选取2012年6月～2014年12月在潍坊市妇幼保健院新生儿科住院并诊断为小于胎龄儿的早产儿，将其按不同胎龄和出生体重分组，早期应用肠内联合肠外营养支持方法，定期监测患儿头围、体重等体格发育指标，并统计分析住院期间合并症以及宫外生长迟缓发生例数等。 结果 ①≥34周组和1.5 kg组患儿头围和体重增长较大，34周组和≥1.5 kg组患儿头围和体重增长较小；出生体重大的组恢复出生体重时间短，发生宫外发育迟缓的例数少（P0.05）。②不同胎龄组中，患儿的体重和头围均呈增长趋势，与34周组相比，≥34周组增加较多，差异具有统计学意义（P0.05）；并且随着胎龄的增加，患儿恢复出生体重所需时间呈缩短趋势（P0.05）。③早产儿中小于胎龄儿常见合并症为新生儿窒息、低血糖症、高胆红素血症、新生儿呼吸窘迫综合征、颅内出血、先天畸形等，且34周组患儿的感染、喂养不耐受发生率明显高于≥34周组（P0.05）。 结论 早期应用肠内联合肠外营养有助于促进小于胎龄儿宫外生长发育，降低宫外生长发育迟缓（EUGR）的发生率，减少住院期间相关并发症。 　　[关键词] 婴儿；小于胎龄儿；营养支持；宫外生长发育迟缓 　　[中图分类号] R722 [文献标识码] B [文章编号] 1673-9701（2015）26-0052-04 　　Effect on parenteral and enteral nutrition on premature neonates with SGA 　　HOU Xiaojing1 ZHANG Chengyuan2 FENG Zijian2 　　1.Weifang Medical University，Weifang 261041，China；2.Neonatal Department，Weifang City Maternal and Child Care Service Centre，Weifang 261011，China 　　[Abstract] Objective To investigate the early effect of parenteral and enteral nutrition on premature neonates with SGA. Methods This retrospective analysis was conducted on hospitalization data of 107 premature neonatal with SGA receiving parenteral and enteral nutrition（PN and EN） in NICU from Jun 2012 to Dec 2014. The patients were assigned into two groups with the different GA and birth weight， and monitored the head circumferences， triglyceride and other indicators. The complications were statisticed. Results Compared with more 1.5 kg and less 34 W group， the head circumferences and weights gained more in less 1.5 kg group and more 34 W group. Time of regaining birth weight were shorter and with fewer case of EUGR in more 1.5 kg group. In different GA group， the head circumferences and birth weights showed an increasing trend， the more 34 W added more. Neonatal asphyxia， hypoglycemia， hyperbilirubinemia， RDS， intracranial hemorrhage and congenital malformation were shown as the common complications of premature neonates with SGA. The inciden