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新生儿重症监护病房极低出生体重早产儿的联合营养

Combined Nutrition in Very-Low-Birth-Weight Preterm Infants in the Neonatal Intensive Care Unit.

作者信息

Jiménez-Jiménez José Ramón, Sierra-Ramírez Jose Alfredo, Rivas-Ruiz Rodolfo, Cruz-Reynoso Leonardo, Hernández-Caballero Marta Elena

机构信息

Neonatal Intensive Care Unit, Hospital de Gineco Obstetricia No. 3, Dr. Víctor Manuel Espinoza de los Reyes Sánchez, Centro Médico Nacional La Raza, Mexico CIty, MEX.

Postgraduate Studies and Research Section, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, MEX.

出版信息

Cureus. 2023 Aug 9;15(8):e43202. doi: 10.7759/cureus.43202. eCollection 2023 Aug.

DOI:10.7759/cureus.43202
PMID:37692741
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10487275/
Abstract

Background Adequate nutritional support is crucial for achieving optimal growth and development in very-low-birth-weight (VLBW) preterm infants. This study evaluated the efficacy of combined nutrition (CN) (parenteral plus enteral nutrition (EN)) as an alternative nutrition protocol for VLBW infants in the neonatal intensive care unit (NICU). Methods This retrospective cohort study collected clinical and growth data from the medical records of VLBW infants weighing between 1,000 and 1,500 grams in the NICU of the Hospital of Obstetrics and Gynecology "Dr. Víctor Manuel Espinosa de los Reyes Sánchez" of the Centro Médico Nacional "La Raza" Instituto Mexicano del Seguro Social, Mexico. Parenteral nutrition (PN) alone or CN (PN plus EN) was used for nutritional management. Statistical tests, such as Student's t-test, Mann-Whitney U test, and chi-square test as appropriate, were used to compare the clinical characteristics and growth data of the two groups, and relative risk was calculated to determine the probability of comorbidities according to feeding type. Statistical significance was set at p<0.05. Results The study included 90 VLBW infants, with 27 receiving PN alone and 63 receiving CN. No statistically significant differences were found concerning sex, age, or Apgar score. The CN group showed better weight gain with statistically significant differences at 28 days (p=0.002), with no increase in the relative risk of necrotizing enterocolitis (NEC) or other complications. Conclusions The CN protocol met the caloric and nutritional needs, without increasing morbidity and mortality. The protocol had a positive impact on weight gain and a shorter NICU stay and should be considered as a nutritional alternative for VLBW infants.

摘要

背景

充足的营养支持对于极低出生体重(VLBW)早产儿实现最佳生长发育至关重要。本研究评估了联合营养(CN)(肠外营养加肠内营养(EN))作为墨西哥社会保障局国家医疗中心“拉扎”分院“维克托·曼努埃尔·埃斯皮诺萨·德洛斯雷耶斯·桑切斯博士”妇产科医院新生儿重症监护病房(NICU)中VLBW婴儿的替代营养方案的疗效。

方法

这项回顾性队列研究收集了墨西哥社会保障局国家医疗中心“拉扎”分院“维克托·曼努埃尔·埃斯皮诺萨·德洛斯雷耶斯·桑切斯博士”妇产科医院NICU中体重在1000至1500克之间的VLBW婴儿病历中的临床和生长数据。采用单纯肠外营养(PN)或CN(PN加EN)进行营养管理。根据情况使用统计检验,如学生t检验、曼-惠特尼U检验和卡方检验,比较两组的临床特征和生长数据,并计算相对风险以确定根据喂养类型发生合并症的概率。统计学显著性设定为p<0.05。

结果

该研究纳入了90名VLBW婴儿,其中27名仅接受PN,63名接受CN。在性别、年龄或阿氏评分方面未发现统计学显著差异。CN组在28天时体重增加更好,差异具有统计学显著性(p=0.002),坏死性小肠结肠炎(NEC)或其他并发症的相对风险没有增加。

结论

CN方案满足了热量和营养需求,且未增加发病率和死亡率。该方案对体重增加有积极影响,并缩短了NICU住院时间,应被视为VLBW婴儿的一种营养替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0d/10487275/ca18c11f1d33/cureus-0015-00000043202-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0d/10487275/03d8627a3c13/cureus-0015-00000043202-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0d/10487275/ca18c11f1d33/cureus-0015-00000043202-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0d/10487275/03d8627a3c13/cureus-0015-00000043202-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0d/10487275/ca18c11f1d33/cureus-0015-00000043202-i02.jpg

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