強(qiáng)化母乳喂養(yǎng)對(duì)住院期間極低出生體重兒的影響

王娟　張敏婕　王敏　周勤

【摘要】 目的：回顧性研究強(qiáng)化母乳喂養(yǎng)對(duì)住院期間極低出生體重兒生長發(fā)育及合并癥的影響。方法：收集2011年1月-2014年6月筆者所在醫(yī)院新生兒重癥監(jiān)護(hù)病房收治的符合入選條件的極低出生體重兒，根據(jù)喂養(yǎng)方式不同分為強(qiáng)化母乳喂養(yǎng)組（49例）和早產(chǎn)兒配方奶喂養(yǎng)組（37例），比較兩組極低出生體重兒住院期間生長發(fā)育指標(biāo)和合并癥發(fā)生情況。結(jié)果：強(qiáng)化母乳喂養(yǎng)組患兒住院期間使用靜脈營養(yǎng)時(shí)間短，但兩組差異無統(tǒng)計(jì)學(xué)意義（P=0.164），強(qiáng)化母乳喂養(yǎng)組達(dá)到全腸內(nèi)喂養(yǎng)所需時(shí)間短，兩組差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患兒喂養(yǎng)不耐受、支氣管肺發(fā)育不良、動(dòng)脈導(dǎo)管未閉、壞死性小腸結(jié)腸炎、院內(nèi)感染、視網(wǎng)膜病等發(fā)生率比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論：早產(chǎn)兒強(qiáng)化母乳喂養(yǎng)可達(dá)到與早產(chǎn)兒配方奶喂養(yǎng)相似的生長速率，縮短腸外營養(yǎng)時(shí)間。

【關(guān)鍵詞】 母乳喂養(yǎng)； 早產(chǎn)； 母乳強(qiáng)化劑； 回顧性研究

doi：10.14033/j.cnki.cfmr.2017.29.081 文獻(xiàn)標(biāo)識(shí)碼 B 文章編號(hào) 1674-6805（2017）29-0157-03

Effects of Intensive Breastfeeding on Very Low Birth Weight Children During Hospitalization/WANG Juan，ZHANG Min-jie，WANG Min，et al.//Chinese and Foreign Medical Research，2017，15（29）：157-159

【Abstract】 Objective：To explore the effects of intensive breastfeeding on growth，development and complications of very low birth weight premature infants during hospitalization.Method：Premature infants with weight<1500 g who were admitted to NICU between January 2011 and June 2014，were retrospectively enrolled and divided into two groups.Infants who were fed with fortified human breast milk were named HMF feeding group（n=49），and those who were fed with premature formula were called PF feeding group（n=37）.Data of infants on growth，development and incidence of various complications were compared between the two groups.Result：The duration of parenteral nutrition of the HMF feeding group was shorter than PF feeding group，but there was no statistically significant difference（P=0.164）.The time required for whole bowel feeding of HMF feeding group was shorter than PF feeding group，the differences were statistically significant（P<0.05）.There were no significant differences between the morbidity of feeding intolerance，bronchopulmonary dysplasia，patent ductus arteriosus，retinopathy，bronchopulmonary dysplasia，necrotizing enterocolitis of newborns（P>0.05）.Conclusion：HMF for premature infants may ensure the same growth pattern as those fed by premature formula，and it also can accelerate the enteral feeding process during hospitalization.

【Key words】 Breastfeeding； Premature； Human milk fortifier； Retrospective studies

First-authors address：Wuxi Maternal and Child Health Hospital，Wuxi 214000，China

我國每年早產(chǎn)兒出生人數(shù)占全球早產(chǎn)兒出生總數(shù)的1/10以上，早產(chǎn)兒的健康問題已成為當(dāng)今世界醫(yī)學(xué)和社會(huì)發(fā)展問題[1]。而極低出生體重兒由于其全身臟器發(fā)育極不成熟，呼吸、消化、排泄及免疫功能等均發(fā)育不成熟，住院期間容易發(fā)生各系統(tǒng)的并發(fā)癥。研究顯示極低出生體重兒喂養(yǎng)不耐受及壞死性小腸結(jié)腸炎發(fā)病率高[2]。母乳能提高早產(chǎn)兒喂養(yǎng)不耐受、減少感染及壞死性小腸結(jié)腸炎的發(fā)生[3]。母乳具有營養(yǎng)、免疫和代謝等方面的優(yōu)勢，隨著泌乳時(shí)間的延長，母乳中的一些營養(yǎng)素不能滿足早產(chǎn)兒特別是極低出生體重兒的生長發(fā)育需求，在母乳喂養(yǎng)時(shí)強(qiáng)化母乳，既能使患兒獲得母乳喂養(yǎng)的優(yōu)勢，又能滿足患兒生長發(fā)育的營養(yǎng)需求[4]。……