监测多普勒模式和临床参数可能有助于预测宫内生长受限婴儿的喂养耐受情况。

Monitoring Doppler patterns and clinical parameters may predict feeding tolerance in intrauterine growth-restricted infants.

机构信息

Neonatal Intensive Care Unit, MBBM Foundation, San Gerardo Hospital, Monza, Italy.

出版信息

Acta Paediatr. 2013 Nov;102(11):e519-23. doi: 10.1111/apa.12380.

DOI:10.1111/apa.12380

PMID:23927730

Abstract

AIM

To detect predictors of feeding tolerance in intrauterine growth restriction (IUGR) infants with or without brain-sparing effect (BS).

METHODS

We conducted a case-control study in 70 IUGR infants (35 IUGR with BS, matched for gestational age with 35 IUGR infants with no BS). BS was classified as pulsatility index (PI) ratio [umbilical artery (UAPI) to middle cerebral artery (MCAPI) (U/C ratio)] > 1. Clinical parameters of feeding tolerance - days to achieve full enteral feeding (FEF) - were compared between the IUGR with BS and IUGR without BS infants. Age at the start of minimal enteral feeding (MEF) was analysed.

RESULTS

Achievement of FEF was significantly shorter in IUGR infants without BS than in IUGR with BS. IUGR with BS started MEF later than IUGR without BS infants. Significant correlation of MEF and FEF with UA PI, U/C ratio and CRIB score was found. Multiple linear regression analysis showed significant correlations with CRIB score and caffeine administration (MEF only), and sepsis (FEF only) and U/C ratio (for both).

CONCLUSION

Impaired gut function can be early detected by monitoring Doppler patterns and clinical parameters.

摘要

目的

检测伴有或不伴有脑保护效应（BS）的宫内生长受限（IUGR）婴儿喂养耐受的预测因子。

方法

我们对 70 例 IUGR 婴儿（35 例 IUGR 伴有 BS，与 35 例无 BS 的 IUGR 婴儿按胎龄匹配）进行了病例对照研究。BS 分类为搏动指数（PI）比值[脐动脉（UAPI）与大脑中动脉（MCAPI）的比值（U/C 比值）]＞1。比较了伴有 BS 和不伴有 BS 的 IUGR 婴儿的喂养耐受临床参数-达到完全肠内喂养（FEF）的天数。分析了开始最小肠内喂养（MEF）的年龄。

结果

与 IUGR 伴有 BS 婴儿相比，IUGR 不伴有 BS 婴儿达到 FEF 的时间明显缩短。IUGR 伴有 BS 的婴儿开始 MEF 的时间晚于 IUGR 不伴有 BS 的婴儿。MEF 和 FEF 与 UA PI、U/C 比值和 CRIB 评分呈显著相关性。多元线性回归分析显示，与 CRIB 评分和咖啡因给药（仅 MEF）以及败血症（仅 FEF）和 U/C 比值（两者均相关）显著相关。