【摘要】 目的分析宫外生长迟缓早产儿出院后不同的强化营养强度及时间对其生后1～6月龄体质量、身长、头围等体格生长发育指标的影响,为进一步优化宫外生长迟缓早产儿出院后的营养方案提供依据。方法收集连云港市第一人民医院2016年1月至2018年12月期间住院好转出院的宫外生长迟缓早产儿共178例,随机分为A、B两组,A组给予足量强化营养至校正胎龄40周后改半量强化营养至校正月龄6月龄,B组给予足量强化营养至体质量达同校正胎龄平均体质量的第10百分位(P₁₀)后改半量强化营养至体质量达同校正胎龄平均体质量的第25百分位(P₂₅)。分别在校正胎龄40周、校正月龄1～6月龄进行体格发育指标测定并比较两组的差异。结果 A、B两组早产儿在校正月龄6月龄体质量[（7 643±359）g、（7 452±305）g]、身长[（66.1±1.3）cm、（65.7±1.0）cm]、头围[（42.2±0.7）cm、（42.0±0.6）cm]均达同校正月龄平均体质量、身长、头围的第10百分位(P₁₀)以上;A、B两组早产儿在校正胎龄40周、校正月龄1月的体格发育情况差异无统计学意义（P>0.05）,A组早产儿在校正月龄2～6月龄体质量、身长、头围均超过B组早产儿,差异有统计学意义（P <0.05）;两组中严重宫外生长受限（出院时体质量小于同校正胎龄平均体质量的第3百分位）的早产儿,B组在校正胎龄40周、校正月龄1～6月龄体质量、身长、头围略大于A组,但差异无统计学意义（P>0.05）。结论足量强化营养至校正胎龄40周后改半量强化营养至校正月龄6月龄及足量强化营养至体重达同校正胎龄体重的P₁₀后改半量强化营养至体重达同校正胎龄体重的P₂₅这两种营养策略均能帮助宫外生长迟缓早产儿实现追赶生长,前者较后者总体有优势,但对于严重宫外生长受限的早产儿采用后者效果可能更好。更多还原

【Abstract】 Objective To compare the effects of different strengthening nutrition strategies on growth development(e.g.weight,length,and head circumference) at 1 to 6 months of preterm infants with extrauterine growth restriction after discharge,so as to provide basis for further optimizing the nutrition program of preterm infants with extrauterine growth restriction after discharge.Methods A total of 178 preterm infants with extrauterine growth restriction hospitalized and discharged from NICU in The First Peopled Hospital of Lianyungang City from January 2016 to December 2018 were included and randomly assigned into groups A and B.Group A was given full dose enriched nutrition until the babies reached 40 weeks corrected gestational age and half dose enriched nutrition until they reached 6 months corrected age,while group B was given full dose enriched nutrition until the babiesr weight index reached the 10 th percentile on growth charts with corrected age and half dose enriched nutrition until their weight index reached the 25 th percentile on growth charts with corrected age.The two groups were evaluated and compared when they reached 40 weeks in corrected gestational age and 1 to 6 months in corrected age with growth index.Results The weight [(7 643±359)g,(7 452±305)g],length [(66.1±1.3)cm,(65.7±1.0)cm],head circumference [(42.2±0.7)cm,(42.0±0.6)cm] of both group A and group B had reached the 10 th percentile on growth charts at 6-month corrected age.The difference in growth index between group A and group B was not significant at 40 weeks corrected gestational age and 1 month corrected age(P>0.05).Group A had gained significantly more weight,length and head circumference than group B at 2 to 6 months corrected age(P<0.05).Among the two groups of preterm infants with severe extrauterine growth restriction(weight index at discharge below the 3 th percentile on growth charts with corrected age),group B had gained more weight,length and head circumference than group A at 40 weeks corrected gestational age and 1 to 6 months corrected age,but the difference was not significant(P>0.05).Conclusion Both the strengthening nutrition strategies could help preterm infants with extrauterine growth restriction achieve their catch-up growth.The strategy of full dose enriched nutrition until the babies reached 40 weeks corrected gestational age and half dose enriched nutrition until they reached 6 months corrected age had an overall advantage over the strategy of full dose enriched nutrition until the babies’ weight index reached the 10 th percentile on growth charts with corrected age and half dose enriched nutrition until their weight index reached the 25 th percentile on growth charts with corrected age,but it might be better to choose the latter for preterm infants with severe extrauterine growth restriction.更多还原