【作者】 谢蕙如；

【导师】 柳国胜；

【作者基本信息】 暨南大学 ， 儿科学， 2006， 硕士

【摘要】 目的 探讨低出生体重儿(LBW)早期胃肠道摄入营养的能力，评估与分析早期胃肠道营养与体重增长的关系，从而为住院期间早产儿营养提供临床指导，提高早产儿生存质量。 方法 以71例无并发症LBW为研究对象，均为适于胎龄儿，胎龄32.4周～34.4周，按出生体重进行分组，体重1500g～＜2000g组41例，体重≥2000g～2500g组30例，记录生后第1周与第2周碳水化合物、蛋白质、脂肪、亚麻油酸、液体及热卡摄入量，体重降至最低日龄，恢复到出生体重日龄，出生体重恢复后每天增长情况，并描记逐日营养图和生长曲线图(体重：每日测量，头围、身长：每周测量)，比较分析两组营养的摄入与生长情况。两组新生儿再按达到体重稳定增长期(恢复出生体重第1天)，体重位于平均体重的第10百分之以上或以下分别分为两亚组，比较各亚组营养的摄入情况。 结果 ①按单位体重计算，液体量摄入生后第一周≥2000g～2500g组与1500g～＜2000g组无显著性差异，生后第二周≥2000g～2500g组较1500g～＜2000g组显著增加，能量摄入生后二周≥2000g～2500g组较1500g～＜2000g显著增加；②两组体重下降到最低的天数为生后第4天，生理性体重下降幅度3.3％～4.2％。恢复至出生时体重1500g～＜2000g组为生后第8天，≥2000g～2500g组为生后第9天。稳定期体重的增长量1500g～＜2000g组为17.416±9.8g／kg／d与≥2000g～2500g组为15.208±8.9g／kg／d；③1500g～＜2000g组头围平均每周增长0.79cm：≥2000g～2500g组头围平均每周增长0.74cm。1500g～＜2000g组身高平均每周增长0.84cm：≥2000g～2500g组身高平均每周增长0.85cm；④达稳定体重增长期后，液体量与能量摄入1500g～＜2000g组体重第10百分之以上者较体重第10百分之以下者显著增加。液体量摄入≥2000g～2500g组体重第10百分之以上者与体重第10百分之以下者无显著性差异，能量摄入≥2000g～2500g组体重第10百分之以上者较体重第10百分之以下者显著增加。 结论 1500g～2500gLBW可以早期进行胃肠道营养，按单位体重计算，液体量摄入生后第一周≥2000g～2500g组与1500～＜2000g组无显著性差异，生后第二周≥2000g～2500g组较1500g～＜2000g组显著增加，能量摄入生后二周≥2000g～更多还原

【Abstract】 Objective To investigate the early gastrointestinal nutrition intake ability of low birthweight infants, and to evaluate and analyze the relationships between early gastrointestinal nutrition and weight gain, and, accordingly to suggest a clinical nutritional guidance for preterm infants in hospital stay that improves the quality of survival.Methods 71 low birthweight infants without any complications were studied. They were all term infants with gestational age of 32.4 to 34.4 weeks and were grouped according to their birthweight. 41 infants were in the group of birthweight 1500g ～ <2000g, while 30 were in the group of birthweight ≥2000g～2500g. The quantities of intake of carbohydrates, proteins, lipids, linoleic acid, fluid and calorie of the first two weeks following birth, number of days for weight loss to the minimum, number of days for weight to regain to birthweight, weight gain following weight regained to birthweight were recorded respectively. Daily nutrition intake graph and growth curves (daily measure of weight, and, weekly measure of crown circumference and height) are plotted to analyze and compare the nutritional intake and growth among the two groups of infants. Each of these two groups of infants were further divided into two sub-groups by body weight above or below the tenth percentile of the average body weight, at the time when they reached the stable weight gain period (the first day when weight regained to birthweight), then the intake of nutrition between the two sub-groups was compared.Results ① As per unit of weight, there was no significant difference between the group of birthweight ≥2000g～2500g and the group of birthweight 1500g ～ <2000g in fluid intake in the first week following birth ; In the second week following birth , the group of birthweight≥2000g～2500g had significant increase in fluid intake as compared with the group of birthweightl500g ～ <2000g. The group of birthweight ≥2000g～2500g had also significant increase in energy intake in the second week following birth as compared with the group of birthweight 1500g ～ <2000g. ② Both group had weight loss to the minimum on the fourth day after birth and the physical weight loss was 3.3% ~4.2%. The group of birthweight 1500g ～ <2000g regained weight to birthweight on the eighth day after birth, while the group of birthweight ≥2000g～2500g on the ninth day after birth. Weight gain in the stable weight gain更多还原