摘要
目的:探讨母乳喂养联合静脉营养对早产儿喂养不耐受及生长发育指标的影响,为指导临床早产儿喂养提供参考。方法:选取2023年1月-2025年2月于本院分娩的早产儿80例,简单随机分组法分为对照组(40例)和观察组(40例),对照组予以配方奶联合静脉营养,观察组行母乳喂养联合静脉营养,对比两组喂养情况、血清营养指标[白蛋白(ALB)、前白蛋白(PA)、血红蛋白(Hb)]、生长发育指标[头围增长速率(HCGR)、身长增长速率(LIR)、体质量增长速率(BMIR)],症状改善情况(达全量肠内营养时间、体质量恢复时间)和住院时间,以及喂养并发症发生情况。结果:观察组第7d奶量(47.4±12.8 ml/kg/d)、第14d奶量(100.3±23.5 ml/kg/d)均大于对照组(39.0±10.2 ml/kg/d、82.5±17.6 ml/kg/d),奶量达120ml/kg/d时间(18.16±4.05d)短于对照组(21.37±5.19d)(均P<0.05),奶量达150ml/kg/d/时间与对照组无差异(P>0.05)。干预2周和出院时,两组血清ALB、PA、Hb水平均较干预前改善(P<0.05),干预2周时观察组血清AL、Hb水平均高于对照组(P<0.05),PA水平与对照组无差异(P>0.05);出院时两组血清ALB、PA、Hb水平无差异(P>0.05)。观察组HCGR、LIR和BMIR均大于对照组,达全量肠内营养时间(18.23±3.76d)、体质量恢复时间(9.45±1.68d)和住院时间(27.25±3.93d)均短于对照组(21.07±3.49d、11.13±1.82d、30.96±4.10d),喂养不耐受发生率(17.5%)低于对照组(37.5%)(P<0.05);胆汁淤积和吸入性肺炎发生率与对照组无差异(P>0.05)。结论:母乳喂养联合静脉营养能够减少早产儿喂养不耐受发生,更快达到全量肠内营养,更好地促进其生长发育。
Objective:To explore the influence of the breastfeeding combined with the intravenous nutrition for premature infants on their feeding intolerance and their growth and development indicators.Methods:80 premature infants who were delivered in the hospital were selected and were divided into control group(n=40)and observation group(n=40)according to simple randomization method from January 2023 to February 2025.The premature infants in the control group received the formula milk combined with the intravenous nutrition,whereas the premature infants in the observation group were given the breastfeeding combined with the intravenous nutrition.The feeding status,the levels of the scrum nutritional indicators,such as albumin(ALB),prealbumin(PA)and hemoglobin(Hb),the values of the growth and development indicators,such as head circumference growth rate(HCGR),length growth rate(L1R)and body mass growth rate(BM1R),the symptom improvement status,such as the time to reach full quantity enteral nutrition and the body mass recovery time,the hospitalization time and the occurrence of feeding complications of the infants were compared between groups.Results:The milk volume of the infants in the observation group on the 7th day(47.4±12.8 ml/kg/d)and on the 14th day(100.3±23.5 ml/kg/d)were significantly higher than those(39.0±10.2 ml/kg/d and 82.5±17.6 ml/kg/d)of the infants in the control group.The time of the milk volume reaching 120ml/kg/d(18.16±4.05d)of the infants in the observation group was significantly shorter than that(21.37±5.19d)of the infants in the control group(all P<20.05).There was no significant difference in the time of milk volume reac-hing 150ml/kg/d of the infants between the two groups(P±0.05).After 2 weeks of the intervention and at discharge,the levels of scrum ALB,PA and Hb of the infants in the two groups had improved significantly(P<0.05).After 2 weeks of the intervention,the levels of the scrum AL and Hb of the infants in the observation group were significantly higher than those of the infants in the control group(P<0.05),and there was no significant difference in the PA level of the infants between the two groups(P<0.05).There were no significant differences in the scrum ALB,PA and Hb levels of the infants at discharge between the two groups(P±0.05).The values of the HCGR,L1R and BM1R of the infants in the observation group were significantly higher than those of the infants in the control group.The time to reach full enteral nutrition(18.23±3.76d),the weight recovery time(9.45±1.68d)and the hospitalization time(27.25±3.93d)of the infants in the observation group were significantly shorter than those(21.07±3.49d,11.13±1.82d and 30.96±4.10d)of the infants in the control group.The incidence of feeding intolerance(17.5%)of the infants in the observation group was significantly lower than that(37.5%)of the infants in the control group(P<0.05).The incidence of the cholestasis and the aspiration pneumonia of the infants had no significant difference between the two groups(P>0.05).Conclusion:The breastfeeding combined with the intravenous nutrition for the premature infants can reduce the occurrence of their feeding intolerance,quickly achieve their full quantity enteral nutrition and promote their growth and development.
作者
梁兰
魏广友
潘家华
刘金广
苏曼
聂丽
李秀勤
LIANG Lan;WEI Guangyou;PAN Jiahua;LIU Jinguang;SU Man;NIE Li;LI Xiuqin(Bozhou Municipal People's Hospital,Bozhou,Anhui Province,236800;The First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Hefei)
出处
《中国计划生育学杂志》
2025年第7期1524-1529,共6页
Chinese Journal of Family Planning
基金
国家卫生健康委医药卫科技计划项目(WA2020HK60)。
关键词
早产儿
母乳喂养
静脉营养
喂养不耐受
生长发育
Premature infant
Breastfeeding
Intravenous nutrition
Feeding intolerance
Growth and development
作者简介
通信作者:苏曼,smcyfll@163.com。
