早期足量营养支持在极低出生体重儿宫外生长发育迟缓中的作用

目的探讨强化肠内外营养对极低出生体重儿宫外生长发育迟缓（EUGR）发生率、各临床生长指标的影响。方法采用回顾性研究方法，将本院早期足量营养支持开展前（2005年1月至2008年12月）与开展后（2010年1月至2011年12月）符合入选条件的极低出生体重儿分为对照组和研究组，比较两组患儿宫外生长发育迟缓的发生率和临床观察指标。结果早产儿恢复出生体重时间对照组为（10．26±1．6）d，研究组为（8．19±1．0）d；生理性体重下降最大幅度对照组为（9．8±2．1）％，研究组为（7．0±1．2）％；EUGR发生率（以出院体重评价）对照组为85．7％，研究组为64.3％：以上3个指标两组比较差异均有统计学意义（P〈0．05）；以头围评价对照组为54．3％，研究组为40．5％，两组比较差异无统计学意义（P〉0．05）。结论早期足量营养支持能被极低出生体重儿接受，可缩短生理性体重下降时间及减小生理性体重下降幅度，降低宫外生长发育迟缓的发生率。

The role of early nutritional support in the prevention of infant with very-low-birthweight due to extrauterine growth restriction

Objective To investigate the impact of enriched enteral and parenteral nutrition support on the incidence of very-low-birthweight （VLBW） infants due to extrauterine growth restriction （EUGR）. Methods A retrospective study between Jan.2005 and Dec.2008 was conducted to compare the incidence of VLBW infants. The infants treated in our hospital before early sufficient amount of nutritional support program （from 2005-01 to 2008-12） and those after the implement of the program （from 2010-01 to 2011-12） were divided into control group and study group. The incidence of extrauterine growth restriction （EUGR） and various clinical growth index of these two groups were compared. Results Premature infants in the control group cost （10.26±1.6） days to regain birth weight, while the study group cost （8.19±1.0）days; the maximum amplitude to of physiological weight loss in the control group was （9.8± 2.1）%, while of the study group was （7.0±1.2）%. The incidence of EUGR judged by discharged weight in the control group was 85.7%, while that of the study group was 64.3%. These three indicators showed significant differences between tow groups （P〈0.05）. The incidence of EUGR judged by the head circumference in the control group was 54.3%, while that of the study group was 40.5%, showing significant difference （P〉0.05）. Conclusion Early sufficient amount of nutritional support should be administrated to the very low birthweight infants. This treatment could shorten the time and reduce the weight of physiological decline and physiological weight loss, and reduce the incidence of extrauterine growth restriction, help children for catch-up growth, and help the development of their organs and improve their prognosis.