%0 Journal Article
%T 不同喂养方式对极早产儿静脉营养相关性胆汁淤积影响的临床研究<br>Clinical Study on the Effect of Different Feeding Patterns on Intravenous Nutrition-Related Cholestasis in Very Premature Infants
%A 吴忠安
%A 蒋韵红
%A 路玲
%A 崔凤静
%A 刘冬云
%J Advances in Clinical Medicine
%P 2591-2599
%@ 2161-8720
%D 2024
%I Hans Publishing
%R 10.12677/ACM.2024.1422365
%X 目的：探讨早产儿生后30天内，不同喂养方式对早产儿肠外营养性胆汁淤积(parenteral nutrition- associated cholestasis, PNAC)的影响。方法：选取2017年5月~2023年5月青岛大学附属医院新生儿监护室收治的胎龄 &lt; 32周且体重 &lt; 1500 g的早产儿586例，根据出生后30天内的喂养模式将早产儿分为三组，分别为母乳喂养组，母乳 + 强化剂喂养组，配方奶喂养组，以PNAC发病率为主要观察对象，以谷丙转氨酶异常，住院时间为次要观察对象。结果：分析了来自430名胎龄 &lt; 32周早产儿的数据。三组间胆汁淤积发病率(P = 0.005)，有统计学意义，谷丙转氨酶异常发病率(P = 1)，无统计学意义。将不同组间有统计意义或可能对胆汁淤积产生影响的观察数据纳入二元logistic回归分析显示，与配方奶相比，母乳可看成减少胆汁淤积发生的独立的保护性因素(P &lt; 0.001)，肠外营养时间、晚发败血症为胆汁淤积发生的独立危险因素(P &lt; 0.001)。Cox回归分析显示，母乳喂养组与配方奶喂养组对早产儿出院时间的影响没有差异，胆汁淤积未增加早产儿住院时间延长的风险，早产儿常见并发症发病风险之间无差异。结论：极早产儿生后30天内，与配方奶喂养相比，母乳喂养和母乳 + 强化剂喂养胆汁淤积发病率较低，且母乳喂养可视为减低胆汁淤积发病风险的独立影响因素，不同喂养模式下，早产儿谷丙转氨酶异常发病率及其他常见并发症发病风险无差异，住院时间无差异。<br />
Objective: To investigate the effects of different feeding patterns on parenteral nutrition-associated cholestasis (PNAC) in preterm infants within 30 days after birth. Methods: 586 preterm infants with gestational age &lt; 32 weeks and weight &lt; 1500 g were selected from the neonatal care unit of Affili-ated Hospital of Qingdao University from May 2017 to May 2023. According to the feeding patterns within 30 days after birth, the preterm infants were divided into three groups: breast feeding group, breast milk + fortifier feeding group, and formula feeding group. The incidence of PNAC was the main observation object, and the abnormal alanine aminotransferase and length of hospital stay were the secondary observation objects. Results: Data from 430 preterm infants &lt;32 weeks of ges-tational age were analyzed. The incidence of cholestasis among the three groups (P = 0.005) was statistically significant, while the incidence of abnormal alanine aminotransferase (P = 1) was not statistically significant. Binary logistic regression analysis showed that breast milk was an inde-pendent protective factor for reducing cholestasis compared with formula milk (P &lt; 0.001), and parenteral nutrition time and late sepsis were independent risk factors for cholestasis (P &lt; 0.001). Cox regression analysis showed that there was no difference between the breastfeeding group and the formula feeding group on the discharge time of preterm infants, cholestasis did not increase the risk of prolonged hospital stay of preterm infants, and there was no difference in the risk of common complications of preterm infants. Conclusion: The incidence of cholestasis in very preterm infants within 30 days after birth is lower than that of formula feeding, breastfeeding or breast milk plus fortifier feeding, and breastfeeding can be regarded as an independent factor to reduce the risk of cholestasis. There is no difference in
%K 喂养方式，胆汁淤积<br>Feeding Pattern
%K Cholestasis
%U http://www.hanspub.org/journal/PaperInformation.aspx?PaperID=80605