不同喂养方式对早产儿的影响

【目的】 探讨不同喂养方式对出院后早产儿体格发育及生化指标的影响,为临床早产儿合理喂养指导提供依据。 【方法】 早产儿91例,出生体重均在1 500 g以上。按喂养方式分为5组:1组为早产儿配方,2组为足月儿配方;3组为早产儿配方+母乳;4组为母乳;5组为足月儿配方+母乳。在矫正月龄4~6个月时测量身长、体重,计算身长、体重的Z值,测定血清总蛋白、白蛋白、微量元素等指标。 【结果】 4组身长Z值为负值,体重Z值亦低于其他各组,但差异无统计学意义(P>0.05);其余各组体重和身长的Z值均为正值,组间差异无统计学意义(P>0.05)。4组血清尿素氮低于其余各组(P<0.05),2组血清尿素氮显著高于3、4、5组(P<0.05),和1组之间差异无统计学意义(P=0.126);1组和5组的白蛋白水平之间差异无统计学意义(P=0.947),但均明显高于3组和4组(P<0.05)。其余各血清学指标之间差异无统计学意义(P>0.05)。 【结论】 1)纯母乳喂养儿体格发育和血清白蛋白水平较其他喂养方式低,提示单纯母乳不能完全满足早产儿早期生长发育需要;2)足月儿配方奶喂养的早产儿血清尿素氮偏高,其机制和远期影响有待进一步探讨。

Effects of feeding in different ways on preterm infants.

【Objective】 To investigate the effects of feeding in different ways on physical development and serum index of preterm infants.【Methods】 91 preterm infants whose birth weights were all above 1 500 g.Infants were divided into 5 groups by following feeding ways: preterm-infant formula;term-infant formula;preterm-infant formula and breast milk;breast milk;term-infant formula and breast milk.Weights,lengths were measured at 4~6 months adjusted by gestational age.Z-score of weights and lengths were calculated.Serum total protein,albumin,and micronutrients etc were detected.【Results】 The Z-score of weights and lengths in Group 4 were blow zero,and lower than other groups.But the differences were not significant(P>0.05).The serum levels of BUN in Group 4 was significant lower than other groups(P<0.05) and was significant higher in Group 2 than Group 3,Group 4,Group 5(P<0.05).The serum levels of albumin in Group 1 and Group 5 were significant higher than other groups(P<0.05),but were similar between the two group(P=0.947).There were no significant differences in other serum index levels among the groups(P>0.05).The levels of serum BUN were correlated with the Z-score of length(r=0.228,P=0.04).【Conclusion】 1) Exclusive breast feeding can not provide enough nutrients for matching the early growth and development of preterm infants;2) Further study will be needed to investigate the mechanisms and long effects of high serum BUN levels in preterm infants feeding with term-infant formula.