深度水解蛋白配方奶在早产儿中的临床研究-东南大学学报医学版

深度水解蛋白配方奶在早产儿中的临床研究

单位：东南大学附属中大医院儿科, 江苏南京 210009

分类号：R722

出版年·卷·期（页码）：2015·34·第四期（546-551）

摘要：

目的:探讨深度水解蛋白配方奶(EHF)对胎龄≤34周的早产儿在新生儿监护病房(NICU)住院期间的临床效果。方法:收集胎龄≤34周入院前尚未开始任何肠内喂养的早产儿118例,随机分为两组,观察组喂养EHF(n=58);对照组喂养普通早产儿配方奶(SPF)(n=60)至出院,并制定严格的剔除标准。早产儿在NICU住院期间,根据胎龄、体重、病情规范肠内喂养时间、喂养方式、初始喂养奶量与添加速度、肠外营养液量与成分,记录喂养不耐受(FI)、新生儿坏死性小肠结肠炎(NEC)、肠外营养相关性胆汁淤积症(PNAC)的发生例数以及每日肠内外营养情况及排便情况,监测体格生长发育指标。结果:最终进入研究分析的早产儿101例,观察组50例,对照组51例。观察组FI的发生率显著低于对照组(P<0.05),但两组在NEC、PNAC的发生方面差异无统计学意义(P>0.05)。两组在开奶时间方面差异无统计学意义(P>0.05),且观察组肠外营养总时间、达全肠内营养时间、NICU住院时间都短于对照组,但差异均无统计学意义(P>0.05)。观察组平均每日排便次数显著增多(P<0.01),胎粪排尽时间显著缩短(P<0.01)。两组在NICU住院期间体重日增长速率(g·kg^-1·d^-1)、身长周增长速率(cm·周^-1)、头围周增长速率(cm·周^-1)方面比较差异均无统计学意义(P>0.05)。结论:胎龄≤34周早产儿在NICU住院期间喂养EHF可减少FI发生,促进排便,缩短胎粪排尽时间,并且与喂养SPF相比,早产儿的体格生长发育指标差异无统计学意义。

Objective: To investigate the clinical application of extensively hydrolyzed formula for the preterm infants(gestational age≤34 weeks)during hospitalization in neonatal intensive care unit(NICU). Methods: The preterm infants(gestational age≤34 weeks), hospitalized in NICU between June 2013 to February 2014, who hadn't been fed enterally, were randomly divided into two groups: the observation group and the control group. Totally 118 cases were admitted to the study. 58 cases in the observation group were fed with the extensively hydrolyzed formulas, 60 cases in the control group were fed with standard preterm formulas till discharge. During hospitalization in NICU, according to the gestational age, weight and the condition, feedings were well regulated(time, pattern, the initial feeding amount, adding speed, the fluid volume and composition of parenteral nutrition). Meanwhile, we recorded the cases of feeding intolerance(FI), necrotizing enterocolitis(NEC), parenteral nutrition associated cholestasis(PNAC). Apart from that, physicians in charge of the infants frequently recorded parenteral and enteral nutrition and defecation, simultaneously monitored the growth and development indicators. Results: The preterm infants who enterd the final study were 101 cases. Among them, there were 50 cases in the observation group and 51 cases in the control group. Compared with the control group, the cases of FI were significantly lower in the observation group(P<0.05). While between the groups, the cases of NEC, PNAC were not statistically significant(P>0.05). The time of reaching full enteral feeding, parenteral nutrition, and hospitalization in NICU of the observation group were shorter than those of the control group, but the differences were not statistically significant(P>0.05). Compared with the control group, time of defecating meconium was shorter(P<0.01), daily stool frequency increased(P<0.01). Growth velocity rates in weight(g·kg^-1·d^-1), length and head circumference(cm·week^-1)were not significantly different during hospitalization(P>0.05). Conclusion: Feeding the preterm infants(gestational age≤34 weeks)with extensively hydrolyzed milk protein formula can promote bowel movement of premature infants, shorten the time of defecating meconium, reduce the cases of FI. Furthermore, compared with the preterm infants feeding with SPF, physical growth and development indicators relatively show no differences.

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