早产儿喂养不耐受的危险因素分析

目的 探讨早产儿发生喂养不耐受(FI)的危险因素.方法 对112例早产儿进行回顾性调查分析.以母体异常、羊水异常、脐带异常、胎盘异常、胎膜早破、胎龄、出生体质量、围生期感染、新生儿高胆红素血症、分娩方式等17个高危因素进行单因素分析,采用Logistic回归分析各个危险因素与早产儿发生FI的相关性.结果 112例早产儿中53例发生FI,发生率为47.32%.经单因素分析显示FI组产前因素中分娩方式、胎膜早破、羊水异常、脐带异常,出生后因素中高胆红素血症、贫血、使用肺表面活性物质与无相关因素早产儿比较均无统计学差异.多因素Logistic回归分析显示:宫内窘迫、胎盘异常和围生期感染是FI发病的危险因素;胎龄、产前使用糖皮质激素是发生FI的保护因素.结论 早产儿出生胎龄越小,发生FI的概率越高,产前使用糖皮质激素可减少FI发生,存在宫内窘迫、胎盘异常和围生期感染的早产儿易发生FI,在建立胃肠营养时要区别对待.

Analysis of Risk Factors for Feeding Intolerance in Preterm Infants

Objective To explore the risk factors of feeding intolerance(FI) in preterm infants.Methods Seventeen possible relevant risk factors of amniotic fluid abnormalities,prenatal maternal abnormalities,maternal placental abnormalities,umbilical cord abnormalities,and preterm premature rupture of membrances,gestational age,birth weight,perinatal infections,neonatal hyperbilirubinemia,mode of delivery and others were analyzed by univeriate method;Binary Logistic regression were performed to determine risk factors such as gestation age,birth weight,perinatal infection hyperbilirubinemia,mode of delivery,and so on.Results There were 53 episodes of FI in 112 preterm infants which the incidence was 47.32%.There was no significant influence on feeding of the perterm children through single-factor analysis which showed that prenatal factors in the FI group including mode of delivery,premature rupture of membranes,abnormal amniotic fluid,umbilical cord and after birth factors such as hyperbilirubinemia,anemia,the use of PS compared with the preterm infants without prenatal factors fed on the preterm children.Multiple Logistic regression analysis showed that gestational age and using of glucocorticoids in antepartum were the protection factors in preventing FI and that fetal distress placental abnormality,placental abnormality and perinatal infection were the dangerous factors of predicted FI.Conclusions The lower the gestational age is,the higher the FI is.Using of glucocorticoids in antepartum can decrease the possibilities of FI.The preterm infants with fetal distress,placental abnormality and perinatal infection are prone to FI.The diffe-rence of strategies in enteral feeding practices is emphasized for preterm infants.