Abstract: Objective To analyze the effect of extensively hydrolyzed formula(eHF) in the treatment of feeding intolerance in preterm infants and the effect on hospital infection, in order to provide reference for the clinical treatment of feeding intolerance in preterm infants. Methods A total of 208 cases of preterm infants with feeding intolerance diagnosed and treated in Shandong Heze Municipal Hospital from April 2017 to February 2020 were selected into the clinical trial for eligibility assessment, then were randomly assigned into study group(n=100) and control group(n=100) after screening and exclusion. Children in the control group were fed with standard preterm formula, while children in the study group were fed with eHF. Feeding tolerance indicators, including daily milk intake, time to meconium evacuation, time to full gastrointestinal nutrition, total gastric residual counts(GRV1) in the 7-d period after resumption of breastfeeding, ratio of all-day gastric residual counts/all-day estimated milk intake after resumption of breastfeeding(GRV2) were compared between the two groups, and growth indicators(body weight growth rate, head dimension growth rate), complication incidence [necrotizing enterocolitis(NEC), pathological jaundice, positive fecal occult blood or blood in stool] and incidence of hospital-acquired infections. Results The daily milk intake(t=5.037) of the study group was higher than that of the control group, and the time of foetal excretion(t=9.217), the time to reach full gastrointestinal nutrition(t=15.833), GRV1(t=6.737), GRV2(t=9.956) were lower than those of the control group, and the differences were all statistically significant(P<0.05). The rate of weight gain(t=2.454) and head dimension growth(t=5.469) in the study group was significantly higher than those of the control group(P<0.05). The incidence of the three complications of NEC, pathological jaundice and positive fecal occult blood or blood in stool(χ²=4.310) and the incidence of hospital infections(χ²=4.688) were significantly lower in the study group than in the control group(P<0.05). Conclusions Compared with the standard formula milk for preterm infants, eHF can significantly improve the feeding intolerance of preterm infants, promote growth and development, and reduce the occurrence of hospital-acquired infections. Therefore, eHF can be widely used in clinic for preterm infants with feeding intolerance.

Key words: premature infants, feeding intolerance, extensively hydrolyzed formula, hospital-acquired infections

摘要： 目的 分析深度水解蛋白配方奶治疗早产儿喂养不耐受的效果及对医院感染的影响,为早产儿喂养不耐受的临床治疗提供参考。方法 选取2017年4月—2020年2月于山东菏泽市立医院诊治的208例喂养不耐受的早产儿进入试验资格评估,筛选排除后随机分配,最终研究组、对照组各100例。对照组患儿接受早产儿标准配方奶喂养,研究组患儿接受深度水解蛋白配方奶喂养,对比两组的喂养耐受指标(每日进奶量、胎粪排尽时间、达全胃肠营养时间、复奶后7d内总胃残留次数(GRV1)、复奶后全天胃残余量/全天预计奶量比(GRV2)、生长发育指标(体重、头围增长速度)、并发症发病率(坏死性小肠结肠炎、病理性黄疸、大便潜血阳性或便血)及医院感染的发生率。结果 研究组喂养耐受指标除每日进奶量(t=5.037)高于对照组外,胎粪排尽时间(t=9.217)、达全胃肠营养时间(t=15.833)、GRV1(t=6.737)、GRV2(t=9.956)均低于对照组,差异均有统计学意义(P＜0.05)。研究组体重增长速度(t=2.454)、头围增长速度(t=5.469)均高于对照组,差异有统计学意义(P＜0.05)。研究组的坏死性小肠结肠炎、病理性黄疸及大便潜血阳性或便血三项并发症发病率与医院感染发生率均低于对照组,差异有统计学意义(χ²=4.310、4.688,P＜0.05)。结论 相较于早产儿标准配方奶,深度水解蛋白配方奶可显著改善早产儿喂养不耐受情况,促进生长发育,减少医院感染的发生,临床应用推广价值高。

关键词: 早产儿, 喂养不耐受, 深度水解蛋白配方奶, 医院感染