胎龄别体重Z评分法评价早产极低出生体重儿生后早期营养状况的分析

摘要

Objective To evaluate the nutrition status in very low birth weight at reture birth weight and discharge with Z score of weight for correct age( CA) . Methods 141 appropriate for gestational age( GA) premature infants with hospital stay ex-ceeding 2 weeks but no major congenital diseases were included. Z scores of weight for age were calculated at birth and reture birth weight and discharge. Their clinical data were retrospectively analyzed. Results At all the subgroups( categorized by GA at birth or by nutrition support method or by nutrition status at discharge) ,The Z scores at reture birth weight and discharge were positively related with Z scores at birth(P<0. 001);Different nutrition support method were significantly related with Z score at reture birth weight and discharge(P<0. 001). The lower Z scores at birth, the time of reture birth weight and discharge were longer. Conclu-sion Very low birth weight infants occurred growth retardation during admission. Nutritional support strategy is helpful for nutri-tion condition in premature infants.%目的：采用纠正胎龄别体重Z评分法评估极低出生体重儿入院时、恢复出生体重时与出院时营养状况,探讨其与出生时营养状况、生后营养支持方式、恢复出生体重时间及住院时间之间的关系。方法选择出生胎龄28~33+6周,出生体重<1500g,生后24h内入院,住院时间≥2周新生儿,分别按出生胎龄和营养支持方式、出院时营养状况分组,比较每组出生时、恢复出生体重时和出院时的Z评分,以及恢复出生体重所需时间和住院时间的关系。结果每组患儿出院时Z评分均低于入院时；小出生胎龄组恢复出生体重时和出院时Z评分均高于大胎龄组；营养支持滞后组,恢复出生体重时及出院时Z评分均较积极组更低,滞后组恢复出生体重所需时间和住院时间也均更长；出生时Z评分越低,恢复出生体重时Z评分和出院时Z评分越低,恢复出生体重所需时间和住院时间也越长；差异均有统计学意义( P<0．001)。结论极低出生体重儿生后早期营养状况较出生时差,并与宫内营养状况正相关；积极的营养支持策略可改善其住院期间营养状况。