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目的:探讨极低出生体质量儿(VLBWI)住院期间早期给予积极营养支持对体质量的影响。方法:对178例出生体质量为1 000~1 499 g生后6 h内入院、住院时间超过2周、无畸形或严重并发症,且存活出院的早产儿分为对照组(76例)和改良组(102例)。对照组病儿采用常规的营养支持方式;改良组采取尽早开奶、足量肠外营养支持方案。比较两组病儿摄入的奶量、三大营养素和热量,并比较VLBWI的生长速度和生长迟缓的发生情况。结果:改良组病儿出生后第3和第7天,奶量摄入均高于对照组(P<0.05),第3天,静脉使用糖类均高于对照组(P<0.05)。改良组病儿出生后第3天静脉使用氨基酸、脂肪乳均明显高于对照组(P<0.05)。改良组病儿出生后第3、7和第14天总热量摄入均高于对照组(P<0.05)。住院期间,改良组病儿体质量下降幅度小于对照组,恢复出生体质量的时间缩短,体质量平均增长速度加快(P<0.05)。出院时,改良组病儿生长迟缓发生率(51%)明显低于对照组(67%)(P<0.05)。结论:早期积极营养支持治疗,增加了VLBWI奶量和三大营养素的摄入,明显改善了VLBWI生长状况,减少了宫外生长迟缓的发生率。
OBJECTIVE: To investigate the effect of early nutritional support for very low birth weight children (VLBWI) during hospitalization on body weight. Methods: 178 cases of birth weight of 1 000 ~ 1 499 g within 6 h after admission to hospital, hospital stay for more than 2 weeks, no deformity or serious complications, and surviving discharged preterm children were divided into control group (76 cases) and Modified group (102 cases). The control group of sick children using conventional nutritional support; modified group as soon as possible to open milk, adequate parenteral nutrition support program. The intake of milk, three nutrients and calories were compared between two groups, and the growth rate and growth retardation of VLBWI were compared. Results: The intake of milk in the improved group was higher than that of the control group on the 3rd and 7th day after birth (P <0.05). On the 3rd day, the sugar content in the vein was higher than that of the control group (P <0.05). On the 3rd day after birth, the amino acids and lipid emulsion in the modified group were significantly higher than those in the control group (P <0.05). The intake of total calories in the improved group was higher than that of the control group on the 3rd, 7th and 14th days after birth (P <0.05). During hospitalization, the improvement of group sickness was less than that of control group. The time to restore birth weight was shortened and the average growth rate of body weight was accelerated (P <0.05). At discharge, the prevalence of stunting in the improved group was significantly lower (51%) than in the control group (67%) (P <0.05). Conclusion: Early active nutritional support treatment increased the milk volume of VLBWI and the intake of the three nutrients, significantly improved the growth of VLBWI and reduced the incidence of extrauterine growth retardation.