项崇悟　高丽娟　陈妙

[摘要] 目的 探讨个体发育支持护理对早产儿生长发育的影响。 方法 选择2015年1月～2016年1月在我院收治的早产儿80例，观察组采用标准化肠内联合肠外营养支持，对照组采用传统方法开展营养支持护理，比较干预后两组IgM、IgG及IgA水平与干预后CD4+、CD8+、CD4+/CD8+水平变化，干预后身长增长速度、体重增长速度及骨矿物含量变化情况。 结果 干预后观察组IgM、IgG及IgA水平均显著高于对照组（P<0.05），干预后观察组CD4+、CD8+水平均高于对照组（P<0.05），CD4+/CD8+比值大于对照组（P<0.05），干预后观察组身长增长速度快于对照组（P<0.05），体重增长速度快于对照组（P<0.05），骨矿物含量高于对照组（P<0.05）。 结论 对早产儿开展早期的营养与支持护理，能有效提高患儿免疫能力，促进其生长发育。

[关键词] 个体发育支持护理；早产儿；生长发育；免疫功能

[中图分类号] R473.72 [文献标识码] B [文章编号] 1673-9701（2017）16-0159-04

[Abstract] Objective To discuss the influence of individual development supportive care on growth and development of premature infants. Methods 80 premature infants treated in our hospital from January 2015 to January 2016 were selected. Patients in the observation group were given standardized enteral and parenteral nutrition， and those in the control group were given traditional nutrition supportive care. The IgM， IgG， and IgA levels， changes of CD4+， CD8+， and CD4+/CD8+ levels， growth rate of height， growth rate of weight， and changes of bone mineral content after treatment were compared between two groups. Results The IgM， IgG， and IgA levels after treatment were significantly higher in the observation group than in the control group（P<0.05）. The CD4+ and CD8+ levels after treatment were significantly higher in the observation group than in the control group（P<0.05）， the CD4+/CD8+ value after treatment was significantly higher in the observation group than in the control group（P<0.05）. The growth rate of height and growth rate of weight after treatment were significantly higher in the observation group than in the control group（P<0.05）. The bone mineral content after treatment was significantly higher in the observation group than in the control group（P<0.05）. Conclusion Early nutrition and supportive care can effectively improve the immunocompetence of premature infants and promote their growth and development.

[Key words] Individual development supportive care； Premature infants； Growth and development； Immunologic function

隨着新生儿科诊疗技术的发展，早产儿尤其是极低出生体重儿及超低出生体重儿救治水平显著提高，同时针对早产儿的远期并发症则越来越受到临床关注[1]。其中生长发育不良是导致早产儿体格发育、器官结构及神经运动系统等功能障碍的主要原因，其对患儿神经系统造成负面影响的同时，严重影响患儿生活质量及患儿家庭稳定[2]。有研究报道[3-5]出生后不适当喂养或营养支持是导致早产儿生长发育不良的主要原因。故适当且有效的营养支持与供应是满足早产儿追赶性生长的重点。鉴于早产儿出生后无早期吸吮力量，且其消化道发育不成熟，同时可能受多种外界因素感染，进而引起喂养困难，同时早产儿对热量需求相对较高[6]，胃肠道功能发育不完善，故无法承受所需营养量，故有效加强早产儿胃肠外营养支持十分重要。目前探索有益于早产儿健康的营养管理策略，为更好的提高早产儿生命质量成为提高早产儿预后的重点亦是难点[7]。……