中美两家医院早产儿营养策略的对照研究

目的 对比中美两家医院的早产儿营养支持数据，以期找到差距及改善方法。方法 对2011年1 月至2012 年5 月北京协和医院儿科NICU（PUMCH 组）及2011 年1 月至2012 年1 月美国辛辛那提儿童医学中心辛辛那提大学医院NICU（CCHMC 组）收治的胎龄结果 PUMCH 组74 例、CCHMC 组82 例纳入研究。PUMCH 组胎龄和出生体重均显著大于CCHMC 组（PPPPPPP=0.018）。PUMCH 组败血症发生率显著高于CCHMC 组（32% vs 12%，P结论 PUMCH 组较CCHMC 组肠外营养时间延长、院内感染发生增加。需要推进强化母乳喂养、采取更积极的喂养方案以加快喂养进程。

Comparison of feeding pattern of preterm infants between two hospitals in China and the United States

Objective To compare the feeding pattern of preterm infants between two hospitals in China and the United States. Methods A retrospective cohort study was conducted. Infants < 32 weeks were enrolled from Cincinnati Children''s Hospital Center Cincinnati University Hospital (CCHMC group) between January 2011 and January 2012 and Peking Union Medical College Hospital (PUMCH group) between January 2011 and May 2012. Enteral and parenteral feeding data of the two groups was compared. Results Eighty-two infants in the CCHMC group and 74 infants in the PUMCH group were enrolled. The gestational age and birth weight of infants in the CCHMC group were smaller than the PUMCH group (P<0.01). The total dosage of amino acid (58±30 g/kg vs 24.0(19.6, 32.8) g/kg; P<0.01) and fat 35±16 g/kg vs 14.0(11.0, 22.5) g/kg; P<0.01], in the PUMCH group were higher than the CCHMC group. The duration of parenteral nutrition in the PUMCH group was longer than the CCHMC group(24±10 d vs 8.0(6.0, 11.0) d; P<0.01]. The breast feeding rate in the CCHMC group was higher (94% vs 10%; P<0.01) than in the PUMCH group. The time for achieving full enteral feeding in the CCHMC group was shorter 12.0(10.0, 14.0) d vs 22.4±9.3 d, P<0.01] than in the PUMCH group. The incidences of necrotizing enterocolitis (13% vs 3%; P<0.05) and sepsis (32% vs 12%; P<0.01) in the CCHMC group were higher than in the PUMCH group. Conclusions Preterm infants in the PUMCH group have a prolonged duration of parenteral nutrition and an increased incidence of sepsis compared to the CCHMC group. Fortified human milk feeding and more aggressive enteral feeding proposal in PUMCH is recommended.