Efficacy comparison of different nutrition management schemes for premature infants after hospital discharge
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摘要:目的 比较早产儿出院后不同营养管理方案的效果。方法 前瞻性选取2019年7月—2020年6月出生胎龄 < 34周且出生体质量 < 1 800 g的出院后早产儿为研究对象, 分为定期随访的个体化营养组和未定期随访的常规营养组。比较2组出院后早产儿基本资料、不同年龄体格生长状态及校正年龄1岁时神经心理发育商(DQ)。结果 本研究共纳入出院后早产儿114例，其中个体化营养组65例，常规营养组49例。2组早产儿性别、出生胎龄、体质量、身长、头围、居住环境、监护人学历等比较，差异无统计学意义(P>0.05)。个体化营养组早产儿校正月龄1、3、6、12个月时的年龄别体质量Z值(WAZ)、年龄别身长Z值(LAZ)、身长别体质量Z值(WLZ)、年龄别头围Z值(HCZ)均高于常规营养组，差异有统计学意义(P < 0.05)。个体化营养组早产儿校正年龄1岁时的神经系统适应性、大动作、精细动作、语言、个人社交的DQ高于常规组，差异有统计学意义(P < 0.05)。结论 早产儿出院后实施个体化营养管理有利于其出院后追赶性生长，降低后期神经发育不良风险。Abstract:Objective To compare the efficacy of different nutrition management schemes in treatment of premature infants after hospital discharge.Methods Premature infants with gestational age < 34 weeks and birth weight < 1 800 g after hospital discharge from July 2019 to June 2020 were prospectively selected as research objects, and they were divided into individualized nutrition group with regular follow up and routine nutrition group without regular follow up. The general data, physical growth status at different ages and neuropsychological development quotient (DQ) at the corrected age of 1 year were compared between the two groups after hospital discharge.Results A total of 114 premature infants after hospital discharge were included in this study, including 65 cases in the individualized nutrition group and 49 cases in the routine nutrition group. There were no significant differences in gender, gestational age, body mass, body length, head circumference, living environment and guardian's education level between the two groups (P>0.05). The weight-for-age Z value (WAZ), length-for-age Z value (LAZ), weight-for-length Z value (WLZ) and head circumference-for-age Z value (HCZ) of premature infants in the individualized nutrition group were significantly higher than those in the routine nutrition group at 1 month, 3, 6 and 12 months of corrected month age (P < 0.05). The DQ of adaptability, big movement, fine movement, language and personal social interaction of nervous system in premature infants of the individualized nutrition group were significantly higher than those in the routine nutrition group at 1 year old of corrected age (P < 0.05).Conclusion Individualized nutritional management for premature infants after hospital discharge is conducive to achieve catch-up growth and reduce the risk of neurodysplasia in later stage.
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表 1 2组早产儿基本资料比较(x±s)[n(%)]
基本资料 个体化营养组(n=65) 常规营养组(n=49) χ2/ t P 性别 男 37(56.9) 29(59.2) 0.479 0.105 女 28(43.1) 20(40.8) 0.791 0.094 出生胎龄/周 30.1±1.4 30.9±1.1 1.432 0.112 出生体质量/g 1 353.0±318.0 1 416.0±287.0 0.648 0.089 出生身长/cm 40.7±1.9 41.1±2.5 1.310 0.176 出生头围/cm 27.3±1.3 28.2±1.7 1.158 0.275 居住环境 农村 17(26.2) 12(24.5) 0.635 0.092 城市 48(73.8) 37(75.5) 0.873 0.087 监护人学历 本科及以上 39(60.0) 30(61.2) 1.037 0.093 本科以下 26(40.0) 19(38.8) 0.972 0.081 
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表 2 2组早产儿1岁时神经心理发育的DQ比较(x±s)
组别 n 适应性 大动作 精细动作 语言 个人社交 个体化营养组 65 91.0±15.0* 86.0±13.0* 90.0±14.0* 82.0±13.0* 89.0±11.0* 常规营养组 49 86.0±13.0 79.0±12.0 86.0±11.0 71.0±12.0 82.0±13.0 DQ: 发育商。与常规营养组比较, * P < 0.05。
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