广州医药 ›› 2018, Vol. 49 ›› Issue (5): 18-23.DOI: 10.3969/j.issn.1000-8535.2018.05.005

• 论著 • 上一篇    下一篇

出院后营养管理对新生儿肠道术后体格追赶的效果及其相关因素分析

万卫红1, 吴锦晖2, 罗丽红3, 张思苑3, 孙静2   

  1. 1 广州市妇女儿童医疗中心营养室(广州 510623);
    2 广州市妇女儿童医疗中心临床营养科(广州 510623);
    3 广州市妇女儿童医疗中心新生儿外科(广州 510623)
  • 收稿日期:2018-05-11 出版日期:2018-09-20 发布日期:2021-11-29
  • 通讯作者: 孙静,E-mail:sunjing1.1@163.com

Effect and correlative factor analysis of post-discharge nutrition management on neonate physical catch up growth after bowel surgery

WAN Weihong1, WU Jinhui2, LUO Lihong3, ZHANG Siyuan3, SUN Jing2   

  1. 1 Nutrition Department, Guangzhou Women and Children Medical Center, Guangzhou 510623,China;
    2 Department of Clinical Nutrition, Guangzhou Women and Children Medical Center, Guangzhou 510623, China;
    3 Department of Neonatal Surgery, Guangzhou Women and Children Medical Center,Guangzhou 510623, China
  • Received:2018-05-11 Online:2018-09-20 Published:2021-11-29

摘要: 目的 探讨科学的出院后营养管理对肠道术后新生儿体格追赶的效果,分析影响体格追赶的相关因素。方法 通过营养门诊对出院术后婴儿及社区婴儿进行个体化营养喂养指导和营养咨询,比较两组每月体质量、身长及头围,并随访至生后9月龄。两组生后半年生长趋势行重复测量检验。结果 第1月龄时,手术组患儿体质量、身长、头围均落后于对照组婴儿(P<0.001, P=0.004, P=0.008),第2月龄时,手术组患儿体质量、头围仍落后于对照组(P=0.003,P=0.031),第4月龄时,手术组体质量低于对照组(P=0.012),第5~9月龄,两组体格指标均无明显差异。生后半年内两组的生长趋势差异无统计学意义。前半年身长的增长与出生身长、父母文化以及父亲的不良习惯存在负相关关系,头围的增长与住院天数呈明显负相关关系、与出生以及首诊时的体格状况呈正相关关系。结论 合理喂养对新生儿肠道术后体格追赶有利,帮助其接近正常生长曲线。再次手术可能是导致体质量增长下降的主要因素,但未明显影响身长、头围的正常增长。出生时和就诊时的体格状况、父母教育程度和不良习惯以及住院天数均是影响体格追赶的相关因素。

关键词: 出院后营养管理, 新生儿, 术后追赶, 生长趋势, 相关因素

Abstract: Objective To investigate the effect of scientific nutrition management after discharge on neonatal physical catch-up after intestinal operation, and to analyze the related factors affecting physical catch-up. Methods Individualized nutritional feeding instruction and nutrition consultation were performed on infants and community infants after discharge from hospital through nutrition clinic. The monthly body weight, body length and head circumference were compared between the two groups, and followed up to 9 months old. The growth trend of the two groups in half a year after birth was tested by repeated measurement. Results At the first month of age, the body weight, body length and head circumference of the patients in the operation group were lower than those in the control group (P<0.001, P=0.004, P=0.008). At the second month, the body weight and head circumference of the operation group were still behind those of the control group (P=0.003, P=0.031), and at the fourth month of age, the weight and head circumference of the patients in the operation group were still lower than those in the control group. The body weight of the operation group was lower than that of the control group (P=0.012), and there was no diffence in the physical indexes between the two groups at the age of 5~9 months. There was no statistical significance in growth trend between the two groups within half a year after birth. The growth of body length in the first half of the year had a negative correlation with the length of birth, parents' culture and father's bad habits. The growth of head circumference had a negative correlation with the length of stay in hospital, and had a positive correlation with the physical condition at birth and at first visit. Conclusion Reasonable feeding is beneficial to the physical catch-up of the newborn after intestinal operation and helps them approach the normal growth curve. Reoperation may be the main cause of weight loss, but it does not affect the normal growth of body length and head circumference. The physical condition at birth and medical visit, parents' education level, bad habit and hospitalization days were all related factors of physical catch-up.

Key words: Discharge nutrition management, Newborn, Postoperative catch-up, Growth trend, Related factors