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目的探讨早产儿发生喂养不耐受(FI)的危险因素。方法对112例早产儿进行回顾性调查分析。以母体异常、羊水异常、脐带异常、胎盘异常、胎膜早破、胎龄、出生体质量、围生期感染、新生儿高胆红素血症、分娩方式等17个高危因素进行单因素分析,采用Logistic回归分析各个危险因素与早产儿发生FI的相关性。结果 112例早产儿中53例发生FI,发生率为47.32%。经单因素分析显示FI组产前因素中分娩方式、胎膜早破、羊水异常、脐带异常,出生后因素中高胆红素血症、贫血、使用肺表面活性物质与无相关因素早产儿比较均无统计学差异。多因素Logistic回归分析显示:宫内窘迫、胎盘异常和围生期感染是FI发病的危险因素;胎龄、产前使用糖皮质激素是发生FI的保护因素。结论早产儿出生胎龄越小,发生FI的概率越高,产前使用糖皮质激素可减少FI发生,存在宫内窘迫、胎盘异常和围生期感染的早产儿易发生FI,在建立胃肠营养时要区别对待。
Objective To explore the risk factors for feeding intolerance (FI) in preterm infants. Methods 112 cases of premature children were retrospectively analyzed. Univariate analysis was performed on 17 risk factors such as maternal abnormality, amniotic fluid abnormality, abnormal umbilical cord, abnormal placenta, premature rupture of membranes, gestational age, birth weight, perinatal infection, neonatal hyperbilirubinemia and delivery mode Logistic regression was used to analyze the association between risk factors and FI in preterm infants. Results Of the 112 premature infants, 53 cases had FI, with a rate of 47.32%. Univariate analysis showed that the mode of delivery, premature rupture of membranes, amniotic fluid abnormalities, umbilical cord abnormalities, postnatal factors of hyperbilirubinemia and anemia in prenatal factors in FI group were significantly higher than those in non-related preterm infants No statistical difference. Multivariate logistic regression analysis showed that intrauterine distress, placental abnormality and perinatal infection were risk factors for FI. Gestational and prenatal glucocorticoid were the protective factors of FI. Conclusion The smaller the gestational age of preterm infants, the higher the probability of occurrence of FI. Prenatal glucocorticoid can reduce the occurrence of FI. There are FI in preterm infants with intrauterine distress, placental anomalies and perinatal infections. Nutrition should be treated differently.