摘要
目的:探讨双胎早产儿喂养不耐受(FI)的临床特征及相关危险因素.方法:回顾性分析2021年1月至2023年4月入住武汉科技大学附属孝感医院新生儿科170例双胎早产儿临床资料,按照住院喂养情况分为喂养耐受组和FI组,总结双胎早产儿FI的临床特征和高危因素.结果:①双胎早产儿FI发生率31.2%(53/170),男女性别比为1∶1.04;双胎均发生FI者38例(22.4%),双胎之一发生FI者15例(8.8%).②临床表现胃潴留+腹胀21例(39.6%),胃潴留+呕吐7例(13.2%),三种症状并存5例(9.4%);喂养计划失败20例(37.7%).③单因素分析结果显示,两组患儿在胎龄、体质量、窒息、胎膜早破、围生期感染、机械通气、使用枸橼酸咖啡因、首次排便时间、胎便排净时间、开奶时间、消化道出血、胎便排出延迟、开奶奶源方面比较差异有统计学意义(P<0.05),而在性别、分娩方式、产前使用糖皮质激素、试管婴儿、孕期合并糖尿病、高血压、贫血、肝内胆汁淤积症、甲状腺功能减退症及孕妇年龄方面比较差异无统计学意义(P>0.05).④多因素Logistic回归分析显示胎龄、体质量、母乳喂养是FI发生的保护性因素,窒息是FI发生的危险因素.结论:双胎早产儿喂养不耐受的临床特点主要表现为胃潴留、腹胀及呕吐,胎龄、体质量、窒息、母乳喂养与FI发生关系密切.
Abstract
Objective:To investigate the clinical features and related risk factors of feeding intolerance(FI)in twin preterm infants.Methods:The clinical data of 170 twin preterm infants admitted to the Neona-tal Department of Xiaogan Central Hospital from January 2021 to April 2023 were retrospectively ana-lyzed,and they were divided into feeding tolerance group and FI group according to the in-hospital feeding conditions,and the clinical characteristics and risk factors of FI in twin preterm infants were summarized.Results:(1)The incidence of FI in premature twins was 31.2%(53/170),and the sex ratio was 1∶1.04.FI occurred in 38 cases(22.4%)in which both twins had FI,and 15 cases(8.8%)in which one of the twins had FI.(2)There were 21 cases(39.6%)of gastric retention and abdominal distension,7 cases(13.2%)of gastric retention and vomiting,and 5 cases(9.4%)of the three symp-toms co-existed.The feeding plan failed in 20 cases(37.7%).(3)By single-factor analysis,signifi-cant differences were found in gestational age,body weight,asphyxia,premature rupture of mem-branes,perinatal infection,mechanical ventilation,use of caffeine citrate,first defecation time,fetal stool clearance time,feeding initiation time,gastrointestinal bleeding,delayed fetal stool discharge and feeding sources between the two groups(P<0.05).There was no significant difference in gen-der,mode of delivery,prenatal use of glucocorticoids,in vitro fertilization,diabetes mellitus,hyper-tension,and anemia during pregnancy(P>0.05).(4)Multivariate logistic regression analysis showed that gestational age,body weight,and breastfeeding were protective factors for FI,and asphyxia was a risk factor for FI.Conclusion:The clinical characteristics of feeding intolerance in twin preterm in-fants are mainly gastric retention,abdominal distension,and vomiting.Gestational age,weight,as-phyxia,and breastfeeding are closely related to FI.
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