极低、超低出生体重儿84例营养状况分析

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【目的】通过三种不同的营养评价方法对极低与超低出生体重儿进行营养评估,探讨早产儿理想的营养评价方法。【方法】84例极低出生体重儿(包括超低出生体重儿)按照肠外营养(parentaral nutrition,PN)应用的时间分为两组,记录两组出生体重及住院期间的体重变化,将患儿体重生长指标进行统计,应用三种方法,即Mounla营养评价法、以宫内生长速度为标准的判断方法、日均体重增长曲线与Christensen体重生长曲线对比的方法,来评估不同营养方式患儿的营养状况。【结果】根据Mounla营养评价方法,两组营养状况组成差异无统计学意义;根据宫内生长速度为标准进行评估,两组住院期间平均体重增长均>15g/(kg.d),两组比较差异有统计学意义(t=3.731,P<0.05);将两组日均体重增长曲线与Christensen体重生长曲线对比,发现四项体重生长指标落后于Christensen曲线数值,PN时间较长的组2指标明显落后。【结论】应用三种营养评价方法评估不同营养方式的患儿的营养状况,得出不同的结论。推测评估极低、超低出生体重儿的营养状况,以宫内生长速度为标准的判断方法过于简单,Mounla营养评价方法可能不够全面,而Christensen体重生长曲线是否适合中国儿童尚不确定,更合理的营养评估方法有待进一步扩大样本量进行深入研究。 【Objective】 Nutritional assessment of very low and very low birth weight infants through three different nutrition evaluation methods is carried out to discuss the ideal nutrition evaluation method of premature infants. 【Methods】 Eighty-four cases of very low birth weight children (including those with low birth weight) were divided into two groups according to the time of application of parental nutrition (PN). The birth weight and changes of weight during hospitalization were recorded. Children body weight growth index statistics, the application of three methods, namely Mounla nutrition evaluation method to determine the rate of intrauterine growth rate method, the average daily weight gain curve and Christensen weight growth curve comparison method to assess the different nutritional means in children Nutritional status. 【Results】 According to the method of Mounla nutrition evaluation, there was no significant difference in the nutritional status between the two groups. According to the intrauterine growth rate as the standard, the average weight gain during hospitalization was> 15g / (kg · d) in both groups (T = 3.731, P <0.05). Comparing the average body weight growth curve with Christensen body weight growth curve, it was found that the four body weight growth indicators lag behind the Christensen curve values, and the group 2 index with longer PN time Obviously behind. 【Conclusion】 Three nutritional evaluation methods were used to evaluate the nutritional status of children with different nutritional status and draw different conclusions. It is too simplistic to speculate on the nutritional status of very low birth weight and very low birth weight infants and to judge the rate of intrauterine growth. Mounla’s nutritional assessment may not be comprehensive enough and it is not yet clear whether Christensen’s weight growth curve is appropriate for Chinese children. The nutritional assessment method needs to be further expanded sample size for further study.
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