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一项非随机干预研究表明,早期积极的营养支持可有效减少早产儿的产后生长受限。

Nonrandomised interventional study showed that early aggressive nutrition was effective in reducing postnatal growth restriction in preterm infants.

机构信息

Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.

Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità Hospital, Novara, Italy.

出版信息

Acta Paediatr. 2017 Oct;106(10):1589-1595. doi: 10.1111/apa.13958. Epub 2017 Jul 14.

Abstract

AIM

This study evaluated whether an early aggressive nutrition (EAN) strategy could limit extrauterine growth restriction (EUGR) in a cohort of preterm infants.

METHODS

This prospective nonrandomised interventional study was carried out in the neonatal intensive care unit of an Italian hospital from January 2013 to December 2015. The prevalence of EUGR was assessed in 100 infants with a gestational age of ≤34 weeks, 50 after the introduction of an EAN regimen in October 2014 and 50 before.

RESULTS

The prevalence of EUGR at discharge was significantly lower after the introduction of EAN than before for weight (34% vs. 66%), head circumference (22% vs. 42%) and length at discharge (20% vs. 48%). The Z-scores for all measurements were significantly higher after the introduction of EAN. In the EAN group, weight velocity was significantly higher and maximum weight loss and negative changes in the Z-scores from birth to discharge for weight were lower than in the pre-intervention controls. In extremely low birthweight subjects, the weight Z-score and weight velocity were significantly higher in the EAN group than the control group.

CONCLUSION

The use of EAN at a very early age reduced EUGR and improved auxological outcomes in preterm infants.

摘要

目的

本研究旨在评估早期积极营养(EAN)策略是否可以限制早产儿宫外生长受限(EUGR)。

方法

这是一项前瞻性、非随机的干预性研究,于 2013 年 1 月至 2015 年 12 月在意大利一家医院的新生儿重症监护病房进行。评估了 100 名胎龄≤34 周早产儿的 EUGR 发生率,其中 50 名婴儿在 2014 年 10 月引入 EAN 方案后,50 名婴儿在引入前。

结果

与引入 EAN 前相比,引入 EAN 后出院时 EUGR 的发生率显著降低,体重(34% vs. 66%)、头围(22% vs. 42%)和出院时的身长(20% vs. 48%)。所有测量值的 Z 评分在引入 EAN 后均显著升高。在 EAN 组中,体重增长率显著高于对照组,最大体重减轻量和体重的 Z 评分从出生到出院的负变化也低于对照组。在极低出生体重儿中,EAN 组的体重 Z 评分和体重增长率显著高于对照组。

结论

在极早期使用 EAN 可减少早产儿的 EUGR 并改善其体格发育结局。

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