不同喂养方式下双头单体女婴的营养状况观察

目的 观察不同喂养方式下双头单体女婴的营养状况.方法 以2011年5月10日收治的1例双头单体女婴为研究对象,在住院152 d期间,双头单体女婴因病情需要在不同阶段共采取5种不同喂养方式,分别为经口＋静脉营养（口服＋静脉）、全肠道内（口服）、全肠道内（持续鼻饲）和全静脉营养、经鼻＋静脉营养（间断鼻饲注入＋静脉）,共喂养147 d.分别对不同营养支持方式下连体婴儿的体重、静息能量消耗量、热卡总量进行监测并统计,同时,观察不同营养支持方式下婴儿的不耐受率.结果 在体重变化量上,全肠道内（持续鼻饲）营养方式促进婴儿体重的增长量最大（P＜0.05）;在静息能量消耗上,部分静脉（经口＋静脉）营养方式消耗量最低（P＜0.05）;在热卡总量供给上,全肠道内（经口）供给热量最多（P＜0.05）.在全部喂养方式中,全肠道内（口服）的喂养不耐受率（最高）为20.5％,而全肠道内（持续鼻饲）的喂养不耐受率（最低）为5.7％.结论 综合体重增长量、静息能量消耗量、热卡总量、耐受率及药物安全因素等考虑,部分静脉营养（间断鼻饲注入＋静脉）是较为安全、有效的连体婴儿营养支持方式.

Nutritional Status of conjoined Twin Baby Girls in Different Feeding Patterns

Objective To observe the nutritional status of conjoined twin baby girls in different feeding patterns. Methods The conjoined twin baby girls with a single body and two heads were admitted to our hospital on May 10, 2013, who was taken as the research sub- ject and the 5 kinds of different feeding ways were adopted according to the needs of disases condition during 152 d of hospitalization, including peroral and parenteral nutrition （oral ＋vein）, total intestinal （oral）, total intestinal （continuous nasal feeding）, total parentera] nutrition and pernasal and parenteral nutrition （intermittent nasal feeding＋vein） respectively, for feeding 147 d. The body mass, resting energy expenditure and total calories of conjoined twins were monitored and performed the statistics, and at the same time, the baby in- tolerance rate under the different nutritional support ways was observed. Results In the body mass variation, the total intestinal nutrition way （continuous nasal feeding） had the maximal increment for promoting the body mass growth（P 〈 0.05）; in the resting energy expenditure, the consumption of the partial intravenous nutrition way （peroal ＋ vein） was lowest（P 〈0.05）; in the total calories supply, the total intestinal nutrition way （peroal） had the maximal calories supply（P〈 0. 05）. In all feeding ways, the total intestinal teeding way was the easiest to cause the feeding intolerance, accounting for 20.5%, and the total intestinal feeding （continuous nasal feeding） had the lowest intolerance rate of 5.7%. Conclusion In the comprehensive consideration of the body mass increment, resting energy expenditure, total calories, tolerance rate and medication safety factors, the partial parenteral nutrition （intermittent nasal feeding ＋venous） is a relatively safe and effective way of nutritional support for the conjoined twins.