住院期间影响极低出生体重儿体重增长的多因素分析

目的 探讨影响极低出生体重儿(VLBWI)体重增长的院内相关因素.方法 对1998年1月至2007年12月我院新生儿重症监护病房(NICU)收治的151例VLBWI进行回顾性分析.根据出院时体重是否达到纠正胎龄第10百分位数分为迟缓组和非迟缓组,分别为104例和47例.结果 两组之间胎龄、出生体重、恢复出生体重日龄、体重下降百分比、日平均体重增长差异均有统计学意义.生后第1、2周迟缓组摄人热量、胃肠内摄入热量、多种氨基酸和总入量均低于非迟缓组,差异有统计学意义.Logistic回归分析发现胎龄(OR=0.140,95%CI 0.051～0.385,P=0.000)、出生体重(OR=1.016,95%CI 1.006～1.026,P=0.002)、第1周多种氨基酸量(OR=47.565,95%CI 1.386～1632.621,P=0.032)和第1周胃肠内热量(OR=23.643,95%CI 1.211～234.877,P=0.042)是影响体重增长的危险因素.结论 VLBWI生后应保证足够的热量、多种氨基酸和总入量,小于胎龄儿和有严重并发症的患儿更应加强营养,合理应用胃肠外营养.

Multiple-factor analysis associated with weight gain of very low birth weight infants during hospitalization

Objective To investigate the assciated factors of weight gain in hospitalized very low birth weight infant(VLBWI). Methods One hundred and fifty-one cases of VLBWI admitted to NICU of the Third Hospital of Peking University from Jan. 1998 to Dec. 2007 were analyzed retrospectively. Results All VLBWls were divided into small for gestational age (SGA) group (n= 104) and non-SGA group (n=47) based on the weight at discharge. There was statistical significance in gestational age, birth weight, the date of coming back to birth weight, percentage of weight loss, average daily weight gain between the two groups. The SGA group had lower intake of energy, proteins and fluid in the first and second week after birth. Logistic regression showed that the influencing factors on weight gain were gestational age(OR=0. 140,95% CI 0. 051-0. 385 ,P=0. 000), birth weight(OR= 1. 016,95 % CI 1. 006-1. 026, P=0.002), protein intake during the first week (OR =47. 565,95% CI 1. 386-1632. 621,P=0.032)and enteral energy of first week(OR=23. 643,95 % CI 1. 211-234. 877,P=0.042). Conclusions Sufficient supply of energy, protein and fluid should be given to VLBWI, especially to those with SGA or severe complications.