极低出生体重早产儿两种肠道外营养方式的对比分析  

Clinical analysis of two different parenteral nutrition for very low birth weight premature infant

作　　者：唐云丽[1,2] 黎惟广 周银凤 

机构地区：[1]广西桂林市人民医院新生儿科,541002 [2]湖南省长沙市第四医院儿科

出　　处：《中国新生儿科杂志》2010年第1期28-31,共4页Chinese Journal of Neonatology

摘　　要：目的探讨传统肠道外营养(TTPN)与早期肠道外营养(ETPN)的不同效果。方法2000年1月至2008年4月我院收治的生后24 h内入院的极低出生体重早产儿,2006年以前入院为TTPN组,2006年以后入院为ETPN组。TTPN组出生24 h后给予氨基酸0.5 g·kg^(-1)·d^(-1),每日递增0.25～0.5g/kg,出生第3天给予脂肪乳0.5 g·kg^(-1)·d^(-1),每日递增0.25～0.5g/kg;ETPN组出生12～24 h给予氨基酸1.0 g·kg^(-1)·d^(-1),每日递增0.5 g/kg,出生24 h给予脂肪乳0.5～1.0 g·kg^(-1)·d^(-1),每日递增0.5 g/kg。观察生后1周内非蛋白热卡(不计奶量),生理性体重下降时间、恢复至出生体重时间、体重增长情况、过渡至全肠道营养时间及相关并发症等。结果共入选58例,TTPN组30例,ETPN组28例。ETPN组较TTPN组非蛋白热卡摄入多,体重下降持续时间短,恢复至出生体重时间短,体重增长快,差异有统计学意义(P<0.05);后期相关并发症及过渡至全肠道外营养时间差异无统计学意义(P>0.05)。结论极低出生体重早产儿ETPN比TTPN摄入热量多,体重增长快,可以减少早期营养不良发生,肠道外营养相关并发症无明显增加,对胃肠功能的恢复无明显影响。Objective A comparison between traditional parenteral nutrition （TTPN） and early parenteral nutrition （ETPN） regimen. Methods Fifty eight very low birth weight premature infants admitted within 24 hours after birth between January 2000 and April 2008. Thirty cases were given TFPN, and the others were given ETPN. TFPN group were given amino acids 0. 5 g·kg-1·d-1 at 24 hours after birth with the daily increment of 0. 25-0. 5g/kg, and joined fat emulsion of 0. 5 g·kg-1·d-1 at 3 days after birth with the daily increments of 0. 25-0, 5g/kg. ETPN group were given amino acids 1.0 g·kg-1·d-1 between 12-24 hours of birth with daily increment of 0. 5g/kg, and fat emulsion 0. 5-1.0g·kg-1·d-1 at 24 hours after birth with daily increments 0.5 g/kg. Studied nonprotein calories consumed within one week after birth （except milk）, time duration for physiological weight loss, pondral growth, transitional time to full enteral nutrition and later correlated complications. Results Compared to traditional parenteral nutrition, early parenteral nutrition ingested more nonprotein calories, had shorter time for physiological weight loss, and quicker pondral growth （P 〈 0. 05 ）. Transitional time to total enteral nutrition and later correlative complications were similar （P 〉 0. 05 ）. Conclusion Very low birth weight premature infant given early parenteral nutrition gained more nonprotein calories and quicker pondral growth than the ones given traditional parenteral nutrition. Early parenteral nutrition could avoid early stage of malnutrition. There was no increase on correlative complications and markedly effect on gastrointestinal tract function recovery.

关 键 词：婴儿 极低出生体重 胃肠外营养 临床研究 

分 类 号：R722.6[医药卫生—儿科] R459.3[医药卫生—临床医学]