早产儿早期静脉营养耐受性的探讨  

A study of tolerance of premature infants to parenteral nutrition in their early age

作　　者：柳洁[1] 刘正娟[2] 张振强[3] 

机构地区：[1]大连市妇产医院新生儿科 [2]大连医科大学第二临床学院,116027 [3]大连市妇产医院检验科

出　　处：《新生儿科杂志》2005年第2期53-56,共4页The Journal of Neonatology

摘　　要：目的探讨早产儿生后1-2d对静脉营养的耐受性。方法将不能完全耐受肠道营养的早产儿34例(胎龄29-36周,体重900-1800g),随机分为两组,实验组于生后48h内添加氨基酸及脂肪乳;对照组采用传统的静脉营养方法,即生后第3天应用氨基酸,第5天应用脂肪乳,同时均根据病情尽早经口微量喂养。两组患儿均于生后第1天及第7天采血,监测血清游离脂肪酸、总胆红素、直接胆红素、白蛋白、甘油三脂、总胆固醇,每天监测体重、微量血糖及经皮胆红素值。比较两组患儿恢复出生体重的时间、血清游离脂肪酸、胆红素及血脂的变化。结果1)实验组患儿恢复出生体重的时间较对照组短;2)两组患儿生后相同日龄测得血清游脂肪酸、总胆红素、直接胆红素、甘油三脂、总胆固醇及血清游离脂肪酸与白蛋白的摩尔比均无显著差异。结论早产儿生后1-2d可耐受全或部分肠道外营养。Objective To observe the tolerance of premature infants to parenteral nutrition in the first 1 - 2 days after birth. Methods Thirty-four premature infants, whose gesta-tional age was 29 - 36 weeks, birth weight 900 - 1800 g, were randomly allocated to either treated group or control group. Treated group received amino acids and lipid emulsion within 48 hours of age, and control group received amino acids on the 3rd day and lipid emulsion on the 5th day. Blood samples for free fatty acid, total bilirubin, direct bilirubin, albumin, trig-lyceride and cholesterol concentrations were taken in all infants on the first and seventh day after birth. Weight, blood glucose, transcutaneous bilirubin was perfortmed daily. The period taken to regain birth weigh, levels of free fatty acid, bilirubin, triglyceride and cholesterol were compared in two groups. Results The period taken to regain birth weigh was shorter in treated group than in control group. In two groups, the levels of serum free fatty acid, total bi-lilrubin, direct bilirubin, triglyceride, cholesterol and the molar ratios of free fatty acid to al- bumin had not significant different on the same days after birth. Conclusion Premature infants can tolerate the parenteral nutrition well during the first 1 - 2 days after birth.

关 键 词：早产儿 早期静脉营养 耐受性 血清游离脂肪酸 部分肠道外营养 直接胆红素 总胆红素 甘油三脂 总胆固醇 出生体重 肠道营养 营养方法 微量喂养 胆红素值 微量血糖 脂肪乳 氨基酸 实验组 对照组 白蛋白 生后 患儿 摩尔比 

分 类 号：R722.6[医药卫生—儿科] R644[医药卫生—临床医学]