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目的探讨无乳糖水解蛋白奶粉对极低出生体重儿喂养不耐受及体重增长的影响。方法根据入院单双号将2010年8月至2013年8月在本院新生儿重症监护室住院的极低出生体重早产儿(胎龄≤34周,出生体重≤1 500 g)分为无乳糖水解蛋白奶粉喂养组(简称水解蛋白组)和普通早产儿奶粉喂养组(简称早产儿奶组)。统计两组患儿出生基本情况(出生体重、胎龄、分娩方式、性别、出生时是否存在窒息)、开始喂养日龄、前白蛋白水平、肠道热卡摄入、肠外营养热卡摄入、恢复出生体重所需天数、体重增加指数、肠外营养停止日龄、喂养不耐受发生例数及宫外发育迟缓例数等指标。结果共纳入83例患儿,其中水解蛋白组40例,早产儿奶组43例,两组出生基本情况差异无统计学意义(P>0.05)。水解蛋白组患儿体重增加指数高于早产儿奶组[(13.5±2.4)g/d比(11.9±3.7)g/d,P=0.036],喂养不耐受发生率低于早产儿奶组(28/40比38/43,P=0.038),差异有统计学意义;水解蛋白组患儿宫外发育迟缓(21/40比25/43)和坏死性小肠结肠炎(1/40比2/43)发生率低于早产儿奶组,但差异无统计学意义(P>0.05)。结论无乳糖水解蛋白奶粉能明显降低极低出生体重早产儿喂养不耐受发生率,促进早产儿早期体重增长。
Objective To investigate the effects of lactose-free hydrolyzed milk protein on feeding intolerance and weight gain of very low birth weight infants. Methods According to admission single and double numbers, the number of very low birth weight preterm infants (gestational age ≤34 weeks, birth weight ≤1,500 g) hospitalized in neonatal intensive care unit from August 2010 to August 2013 were divided into lactose-free Hydrolyzed protein powder feeding group (referred to as hydrolyzed protein group) and ordinary premature infant milk powder feeding group (referred to as premature infant milk group). The basic conditions of birth (birth weight, gestational age, mode of delivery, sex and birth asphyxia) of the two groups were counted, the age of beginning feeding, prealbumin level, intestinal heat card intake, parenteral nutrition heat card The number of days needed to recover, birth weight, weight gain index, parenteral nutrition age, number of feeding intolerance, and number of extrauterine stunting. Results A total of 83 children were enrolled. Among them, 40 cases of hydrolyzed protein group and 43 cases of premature infant milk group had no significant difference in basic conditions of birth (P> 0.05). The body weight gain index of the hydrolyzed protein group was higher than that of premature infants [(13.5 ± 2.4) g / d vs (11.9 ± 3.7) g / d, P = 0.036]. The incidence of feeding intolerance was lower than that of premature infants (28/40 vs 38/43, P = 0.038). The difference was statistically significant. In the proteomics group, extrauterine growth retardation (21/40 vs. 25/43) and necrotizing enterocolitis (1/40 to 2 / 43) was lower than that of premature infants, but the difference was not statistically significant (P> 0.05). Conclusion lactose-free hydrolyzed protein milk powder can significantly reduce the incidence of very low birth weight preterm infants fed intolerance and promote early body weight gain in preterm infants.