无乳糖水解蛋白奶粉对极低出生体重儿喂养不耐受和体重增长的影响

摘要

目的 探讨无乳糖水解蛋白奶粉对极低出生体重儿喂养不耐受及体重增长的影响.方法 根据入院单双号将2010年8月至2013年8月在本院新生儿重症监护室住院的极低出生体重早产儿(胎龄≤34周,出生体重≤1500 g)分为无乳糖水解蛋白奶粉喂养组(简称水解蛋白组)和普通早产儿奶粉喂养组(简称早产儿奶组).统计两组患儿出生基本情况(出生体重、胎龄、分娩方式、性别、出生时是否存在窒息)、开始喂养日龄、前白蛋白水平、肠道热卡摄入、肠外营养热卡摄入、恢复出生体重所需天数、体重增加指数、肠外营养停止日龄、喂养不耐受发生例数及宫外发育迟缓例数等指标.结果 共纳入83例患儿,其中水解蛋白组40例,早产儿奶组43例,两组出生基本情况差异无统计学意义(P>0.05).水解蛋白组患儿体重增加指数高于早产儿奶组[(13.5±2.4)g/d比(11.9±3.7)g/d,P=0.036],喂养不耐受发生率低于早产儿奶组(28/40比38/43,P=0.038),差异有统计学意义;水解蛋白组患儿宫外发育迟缓(21/40比25/43)和坏死性小肠结肠炎(1/40比2/43)发生率低于早产儿奶组,但差异无统计学意义(P>0.05).结论 无乳糖水解蛋白奶粉能明显降低极低出生体重早产儿喂养不耐受发生率,促进早产儿早期体重增长.%Objective To study whether a lactose-free,hydrolyzed protein formula would ameliorate feeding intolerance and weight gain in very low birth weight infants.Methods The study was conducted on very low birth weight infants ( gestational age ≤34 weeks, birth weight ≤1500 g) in our NICU from August 2010 to August 2013. According to the number of admission, the cases were assigned into lactose-free hydrolyzed protein formula group ( hydrolyzed protein group) and preterm formula group. The data of basic information ( gestational age, birth weight, way of labor, sex, asphyxia ), commencement of feeding time ( days) , enteral caloric intake, parenteral nutrition caloric intake, The time ( days) required to regain birth weight, weight gain index, days of parenteral nutrition, prealbumin level, feeding intolerance, the incidence of necrotizing enterocolitis ( NEC ) and extrauterine growth retardation(EUGR)werecollected.Results A total of 83 infants were recruited in the study. 40 infants were in hydrolyzed protein group and 43 infants were in preterm formula group. There were no differences between groups for basic information ( P>0. 05). The weight gain index of hydrolyzed protein group was higher than that of preterm formula group (13. 5 ± 2. 4 g/d vs. 11. 9 ± 3. 7 g/d, P=0. 036). There were less cases of feeding intolerance in hydrolyzed protein group than in preterm formula group & nbsp;(28/40 vs. 38/43, P=0. 038). The differences of the incidence of NEC (1/40 vs. 2/43) and EUGR (21/40vs.25/43)showed no significance statistically.Conclusions Lactose-free hydrolyzed protein formula can obviously improve feeding intolerance and early weight gain of premature infants.