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目的了解昆明地区早产儿超声骨密度的基础数据,探究不同喂养方式对其的影响。方法选择本院儿科2012年5月至2013年11月收治的早产儿,生后1周内和校正年龄3个月时利用高频超声骨密度测定仪检测左侧胫骨中1/3段内侧面骨密度,测定身长、体重等发育指标;校正年龄3个月时同时查血磷、血钙、碱性磷酸酶等指标。分析不同喂养方式对早产儿骨密度的影响。结果校正年龄3个月时,混合喂养组早产儿(55例)平均骨密度高于人工喂养组和纯母乳喂养组[(2 768±231)m/s比(2 609±93)m/s、(2 507±90)m/s],人工喂养组高于纯母乳喂养组,差异有统计学意义(P<0.05)。混合喂养组身长、体重、血钙、血磷高于人工喂养组和纯母乳喂养组,碱性磷酸酶低于人工喂养组和纯母乳喂养组,人工喂养组身长、体重、血钙、血磷高于纯母乳喂养组,碱性磷酸酶低于纯母乳喂养组,差异均有统计学意义(P<0.05);无论何种喂养方式,添加维生素D的早产儿骨密度值较未添加维生素D的早产儿明显增高,差异有统计学意义(P<0.05)。结论不同喂养方式对早产儿骨密度存在影响,混合喂养并添加维生素D相对于其他喂养方式可能更能促进骨密度的增长,较低胎龄早产儿母乳喂养需使用母乳强化剂。
Objective To understand the basic data of ultrasonic bone mineral density in premature infants in Kunming and to explore the influence of different feeding methods on it. Methods Preterm infants who were admitted to our hospital from May 2012 to November 2013 were selected. Within 1 week after birth and at 3 months of age of correction, the medial aspect of the middle third of the left tibia was detected by high frequency ultrasound bone mineral density Bone mineral density, determination of body length and weight and other developmental indicators. At the same time, the indexes of blood phosphorus, serum calcium and alkaline phosphatase were detected at the same time of 3 months. The effects of different feeding methods on bone mineral density in premature infants were analyzed. Results The average BMD in preterm infants (55 cases) in mixed feeding group was higher than that in artificial feeding group and pure breastfeeding group (2 768 ± 231) m / s (2 609 ± 93) m / s , (2 507 ± 90) m / s], respectively. The difference between the two groups was statistically significant (P <0.05). The body weight, serum calcium and phosphorus in the mixed feeding group were higher than those in the artificial feeding group and pure breastfeeding group, while the levels of alkaline phosphatase in the mixed feeding group were lower than those in the artificial feeding group and the exclusive breastfeeding group. The body weight, blood calcium, Higher than pure breastfeeding group, alkaline phosphatase lower than pure breastfeeding group, the difference was statistically significant (P <0.05); regardless of the way of feeding, vitamin D in preterm infants with increased bone mineral density than without vitamin D Of premature children was significantly higher, the difference was statistically significant (P <0.05). Conclusion Different feeding methods have an impact on the BMD of premature infants. Mixed feeding and vitamin D supplementation may be more effective in promoting BMD than other feeding methods. Breast enhancement should be used in breastfeeding of premature infants of lower gestational age.