[1]陈 莹,王玉美,陈丹丹,等.营养支持小组对NICU早产儿营养及结局的影响研究[J].肠外与肠内营养杂志,2019,(05):276-280285.[doi:DOI : 10.16151/j.1007-810x.2019.05.005]
　CHEN Ying,WANG Yu-mei,CHEN Dan-dan,et al.Role of a nutrition support team on nutrition and outcomes in preterm infants in NICU[J].PARENTERAL & ENTERAL NUTRITION,2019,(05):276-280285.[doi:DOI : 10.16151/j.1007-810x.2019.05.005]
点击复制

营养支持小组对NICU早产儿营养及结局的影响研究
分享到：

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2019年05期
页码:
276-280285
栏目:
论著
出版日期:
2019-09-10

文章信息/Info

Title:
Role of a nutrition support team on nutrition and outcomes in preterm infants in NICU
作者:
陈 莹 1; 王玉美 1; 陈丹丹 1; 潘兆军 2; 韩良荣 2; 刘 娟 2; 张朝晨3
扬州大学医学院附属淮安市妇幼保健院，1. 儿童保健科；2.新生儿科；3.药剂科，江苏淮安 223000
Author(s):
CHEN Ying1;  WANG Yu-mei1;  CHEN Dan-dan1;  PAN Zhao-jun2;  HAN Liang-rong2;  LIU Juan2;  ZHANG Chao-chen3
1.Department of Child Health；2.Department of Neonatology；3.Department of Pharmacy，Huai'an Maternal and Child Health Hospital Affiliated to Yangzhou University Medical College，Huai'an 223002，Jiangsu，China
关键词:
营养支持小组 ; 早产儿营养 ; 母乳喂养 ; 追赶生长
Keywords:
NST;  Nutrition of preterm infants;  Breast feeding;  Catch-up growth
分类号:
R725.8
DOI:
DOI : 10.16151/j.1007-810x.2019.05.005
文献标志码:
A
摘要:
目的：观察营养支持小组(NST)对新生儿重症监护病房(NICU)早产儿喂养和营养状况及临床结局的影响，探索早产儿院内外营养管理模式。 方法：选取 2017年 3月 1日至 8月 31日于淮安市妇幼保健院 NICU住院治疗（住院时间≥ 2周）的早产儿 141例，随机分为干预组（n = 71）和对照组（n = 70）。干预组由新生儿科医师、护士、儿童营养科医师、营养师及药剂师组成的 NST联合查房，对 NICU早产儿实施综合营养管理模式；对照组由新生儿科医师独立查房，制定常规营养支持方案，由护士实施。比较两组营养状况及临床结局。 结果：干预组母乳喂养率、7 d 内母乳喂养率和母乳强化剂使用率均高于对照组，差异有统计学意义(P < 0.05)。干预组宫外发育迟缓（EUGR）发生率及喂养不耐受发生率均低于对照组，差异有统计学意义(P < 0.05)。干预组静脉营养使用时间低于对照组，差异有统计学意义(P < 0.05)。矫正胎龄至 1岁时干预组早产儿出现追赶生长的发生率高于对照组(P <0.05)；营养不良发生率低于对照组(P < 0.05)。 结论：NST建立对早产儿进行综合管理可以提高 NICU早产儿母乳喂养率，改善其喂养和营养状况，促进早产儿婴儿期的追赶生长。
Abstract:
Objective: To observe the role of a nutrition support team on the feeding and nutritional status and clinical outcomes of premature infants in neonatal intensive care unit (NICU), and explore the nutritional management model in and out of hospital for premature infants. Methods: Premature infants of 141 cases hospitalized in NICU of Huai'an Maternal and Child Health Hospital Affiliated to Yangzhou University Medical College from March 2017 to August 2017 were randomly divided into intervention group (n = 71) and control group (n = 70). The time of hospitalization stay for both groups were over two weeks. The intervention group was checked by the nutrition support team and implemented a comprehensive nutritional management model for preterm infants in NICU, which consisted of neonatal pediatrician, nurses, child nutrition physicians, dietitian and pharmacists together. And the control group was independently checked by neonatal pediatrician and implemented the routine nutrition support program, which were implemented by nurses. The nutritional status and clinical outcomes were compared between the two groups of preterm infants. Results: In the intervention group, the rate of breastfeeding within 7 days and the rate of breast milk fortifier were significantly higher than the control group (P < 0.05). In the intervention group, both the incidence of EUGR and feeding intolerance were lower than that in the control group. The difference was statistically significant between the two groups (P < 0.05). The duration of intravenous nutrition in the intervention group was significantly lower than that in the control group (P < 0.05).The incidence of catch-up growth in the intervention group was higher than that in the control group from corrected gestational age to 1 year old (P < 0.05).The incidence of malnutrition was lower than the control group(P < 0.05). Until corrected age of 1 year, the incidence of catch-up growth was significantly higher in the intervention group than that in the control group(P < 0.05); and the incidence of malnutrition was lower than that in the control group(P < 0.05). Conclusions: The establishment of NST, which provided comprehensive management strategy for premature infants，could improve the breastfeeding rate and nutritional status of premature infants, and promote their catch-up growth in infancy.

参考文献/References:


[1] Wesley JR. Nutrition support teams: past, present, and future.Nutr Clin Pract, 1995,10(6):219-228.
[2] 符 蝶, 邱 瑾, 陈 娇, 等 . 营养支持小组在重症胰腺炎患者治疗中的价值 .中国医师杂志, 2013, (21): 43-44.
[3] 张晓伟, 李增宁, 赵丽华, 等 .营养支持小组对先天性心脏病手术患儿临床结局的影响 . 中华临床营养杂志 , 2014, 22(4):231-233.
[4] 中华医学会肠外肠内营养学分会儿科学组, 中华医学会儿科学分会新生儿学组, 中华医学会小儿外科学分会新生儿外科学组, 等 . 中国新生儿营养支持临床应用指南 . 中华小儿外科杂志, 2013, 34(10): 782- 787.
[5] de Onis M, Onyango A, Borghi E, et al. Worldwide implementation of the WHO Child Growth Standards. Public Health Nutr,2012, 15(9):1603-1610.
[6] 《中华儿科杂志》编辑委员会,中华医学会儿科学分会儿童保健 学组,中华医学会儿科学分会新生儿学组 .早产、低出生体质量 儿出院后喂养建议 . 中华儿科杂志,2016,54(1):6-12.
[7] Bick D. Born too soon: the global issue of preterm birth.Midwifery, 2012,28(4):341-342.
[8] 王丹华 . 规范早产儿喂养提高营养管理水平 . 中华儿科杂志,2016, 54(1): 1-2.
[9] 赵卓琦, 洪 莉, 冯 一, 等 . 早产儿营养干预方式的研究进展 .中华临床营养杂志,2015,23(5):317-322.
[10] Repa A, Thanhaeuser M, Endress D, et al. Probiotics (Lactobacillus acidophilus and Bifidobacterium infantis) prevent NEC in VLBW infants fed breast milk but not formula [corrected]. Pediatr Res, 2015,77(2):381-388.
[11] de Halleux V, Pieltain C, Senterre T, et al. Use of donor milk in the neonatal intensive care unit. Semin Fetal Neonatal Med, 2017,22(1):23-29.
[12] Bertino E, Arslanoglu S, Martano C, et al. Biological, nutritional and clinical aspects of feeding preterm infants with human milk. J Biol Regul Homeost Agents, 2012,26(3 Suppl):9-13.
[13] 陈小慧, 余章斌, 韩树萍 . 捐献母乳与配方奶喂养对极低、超低出生体质量儿的影响 . 中华实用儿科临床杂志, 2016,31(19):1464-1467.
[14] Lipman TO, Munyer TO, Hall C. Parenteral nutrition and nutritional support in Veterans Administration Medical Centers.JPEN J Parenter Enteral Nutr, 1983,7(4):385-386.
[15] 夏韶民, 蔡 威, 汤庆娅 . 营养支持小组: 诞生、运作和价值 . 肠外与肠内营养, 2002, 9(3): 186-189.
[16] Braun K, Utech A, Velez ME, et al. Parenteral Nutrition Electrolyte Abnormalities and Associated Factors Before and After Nutrition Support Team Initiation. JPEN J Parenter Enteral Nutr, 2018,42(2):387-392.
[17] Underwood MA. Human milk for the premature infant. Pediatr Clin North Am, 2013,60(1):189-207.
[18] 姜喜英,盛方明 .系统化健康宣教在 NICU早产儿母乳喂养中的应用效果 .中国实用医药,2017,12(9):181-183.
[19] Briere CE, McGrath JM, Cong X, et al. Direct-breastfeeding in the neonatal intensive care unit and breastfeeding duration for premature infants. Appl Nurs Res, 2016,32:47-51.
[20] Clark RH, Thomas P, Peabody J. Extrauterine growth restriction remains a serious problem in prematurely born neonates.Pediatrics, 2003,111(5 Pt 1):986-990.
[21] 岳 枫, 贾义军, 石计朋 . 早期营养支持对极低出生体重儿生长的影响 .肠外与肠内营养,2014,21(3):155-157,160.
[22] Jeong E, Jung YH, Shin SH, et al. The successful accomplishment of nutritional and clinical outcomes via the implementation of a multidisciplinary nutrition support team in the neonatal intensive care unit. BMC Pediatr, 2016,16:113.
[23] 侯翠萍 . 早期营养管理促进早产儿智力发育与体格发育的价值分析 .中国卫生产业,2018,15(11):17-18,21.
[24] 詹李彬,刘明杰,黄秋妹 .发育监测与早教干预新模式在早产儿出院后保健中的应用分析 .中国临床实用医学,2018,9(6):50-52.

备注/Memo

备注/Memo:
基金项目 ：江苏省青年医学重点人才培养项目（QNRC2016440） 作者简介 ：陈 莹，主治医师，儿科学硕士，从事研究儿童生长发育和营养研究。E-mail:13511557228@126.com 通讯作者 ：王玉美，E-mail: wangyumei418@163.com
更新日期/Last Update: 1900-01-01