目的探讨新生儿呼吸窘迫综合征(RDS)早产儿宫外发育迟缓(EUGR)相关危险因素,以探讨预防对策。方法收集2011年1月1日至2012年10月31日新生儿重症监护室的60例适于胎龄儿的RDS早产儿的临床资料,根据出院时体质量与矫正胎龄的关系,分为EUGR组与非EUGR组,应用SPSS 17.0软件进行数据分析,比较两组基本情况、围产期因素、营养摄入情况、治疗措施及并发症方面的差异;并对相关因素进行Logistic回归分析,筛选出RDS早产儿宫外发育迟缓的高危因素。结果适于胎龄的RDS早产儿宫外发育迟缓发生率为56.67%(34/60)。EUGR组与非EUGR组出生体质量、最小体质量、多胎妊娠、分娩方式差异有统计学意义(P0.05),在胎龄、营养摄入情况、治疗措施及并发症方面差异无统计学意义(P0.05)。Logistic回归分析:恢复出生体质量时间、多胎妊娠为危险因素,产前激素应用为保护性因素。结论适于胎龄的RDS早产儿EUGR与多胎妊娠、剖宫产、出生体质量低、最小体质量有关,恢复出生体质量时间及多胎妊娠为EUGR危险因素。

Objective To explore the epidemiological rule and correlated risk factors of extrauterine growth retardation in premature infants with respiratory distress syndrome(RDS) and to provide prevention and reduce its morbidity. Methods Data of 60 infants with RDS who were appropriate for gestational age incharged from Jan.1.2011 to Oct.30.2012 at the Neonatal Intensive Care Unit of Qingdao Women and Children Hospital were reviewed. According to the weight when he(she) was discharged, all subjects were divided into EUGR group and non-EUGR group.The SPSS 17.0 was applied to analyze the data.The difference of 2 groups in terms of basic situation, peripartum factors, nutritional support, treatment measures and complications were compared.Correlation factors were screened out by Logistic regression analysis. Results Among 60 RDSs who were appropriate for gestational age, 34 cases were extrauterine growth retardation. The differences in birth weight, the minimum weight, multiple pregnancy, deliver

目的探讨胎龄≤32周低出生体重早产儿宫外发育迟缓（EUGR）发生率及其相关影响因素。方法纳入126例胎龄≤32周低出生体重早产儿,记录胎龄（超声或出生时成熟度分析数据）、出生时体重、身长、头围、性别、是否低于胎龄儿、是否存在呼吸窘迫综合征、最大生理性体重减少率、恢复出生体重的天数、起始肠内喂养时间、完全肠内喂养时间（每天奶量〉100 ml/kg·d）,37～42周时测定早产儿体重、身长、头围,以体重、身长和头围计,分析EUGR发生率、其危险因素以及适于胎龄儿（AGA）和低于胎龄儿（SGA）EUGR发生率。结果 EUGR组胎龄、出生体重、出生身长、出生头围均低于非EUGR组（均P〈0.01）,而体重下降率（%）、恢复出生体重时间、起始肠内喂养时间以及完全肠内喂养时间均大于非EUGR组（均P〈0.01）,SGA比例明显大于非EUGR组（均P〈0.05）。以体重、身长、头围计,所有新生儿EUGR发生率分别为47.6%、39.7%和4.8%。总体上SGA宫外发育迟缓率明显高于AGA（均P〈0.01）。胎龄、恢复出生体重时间、完全肠内喂养时间与EUGR发生密切相关。结论胎龄、宫内发育迟缓、营养摄入差及呼吸窘迫综合症仍是胎龄≤32周早产儿EUGR发生的危险因素。

Objective To investigate the incidence and related factors of extrauterine growth retardation (EUGR) in low birth weight preterm children. Methods A total of 126 cases of low birth weight premature children with gestational age≤32 week were enrolled, and gestational age (ultrasound or birth maturity analysis of data), birth weight, length, head circumference, gender, the existence of respiratory distress syndrome, the maximum physiologi-cal weight reduction rate, the number of days to regain birth weight, the time for starting enteral feeding and full enter-al feeding (daily milk>100 ml/kg·d) were recorded. During 37~42 weeks, weight, length, head circumference, body weight, length and head circumference of premature children were measured. Incidence of EUGR and risk factors, and incidences of EUGR in appropriate for gestational age children (AGA) and small for gestational age children (SGA) were analyzed. Results The gestational age, birth weight, birth length, and head ci

目的：探讨早期肠内营养联合肠外营养支持对小于胎龄儿（ SGA）宫外生长发育的影响。方法选取2011至2014年温州市中心医院出生的SGA患儿90例，按照胎龄及出生体重分组：①胎龄分组：≥37周组12例及＜37周组78例；②出生体重分组：≥2．5 kg组36例及＜2．5 kg组54例，均接受早期肠内营养联合肠外营养支持治疗，监测生化指标、体重、头围及恢复出生体重时间；统计宫外发育迟缓（ EUGR）的发生率；评价患儿喂养的耐受情况。结果①不同出生体重组：总胆红素（ TBIL）、胆固醇（CH）、甘油三酯（TG）及尿素氮（BUN）、头围及体重增长情况的差异无统计学意义（t值分别为9．009、9．435、9．221、9．758、10．297、9．502，均P＞0．05）；出生体重≥2．5kg组的恢复出生体重时间（t＝6．663，P＜0．05）及EUGR发生率均显著下降，两组比较差异有统计学意义（χ2＝5．632，P＜0．05）；②不同胎龄组：生化指标（TBIL、CH、TG、BUN）及EUGR的发生率比较，差异无统计学意义（t值分别为11．039、11．445、10．280、10．775，（χ2＝11．457，均P＞0．05）；与胎龄＜37周组相比较，胎龄≥37周组头围及体重增长速度增加，恢复至出生体重的时间显著缩短，两组比较差异有统计学意义（ t

Objective To evaluate the effect of early gastrointestinal nutrition combined with parenteral nutrition on extrauterine growth of small-for-gestational-age (SGA) infants.Methods From 2011 to 2014, totally 90 cases of SGA infants born in Wenzhou Central Hospital were selected, and they were divided into four groups according to gestational age and birth weight: ≥37 weeks group ( n=12 ) , 0.05).The time return to birth weight reduced ( t=6.663,P 0.05).Compared with <37 weeks group, the increasing of head circumference and body weight was faster and the time return to birth weight reduced in≥37 weeks group.The differences were significant (t value was 5.647, 4.090 and 3.677, respectively, all P<0.05). No feeding intolerance was found in any cases.Conclusion Early enteral nutrition combined with parenteral nutrition support is helpful to improve the growth and development of SGA.