早产儿全静脉营养与胆汁瘀积相关性的临床研究  

Clinical study of the relationship between intravenous nutrition and cholestasis in premature infants

作　　者：宫德鸿[1] 李博[1] 

机构地区：[1]山东省枣庄市立医院儿科ICU,277100

出　　处：《中国实用医刊》2012年第5期16-18,共3页Chinese Journal of Practical Medicine

摘　　要：目的为提高危重新生儿全胃肠外营养（TPN）的安全性和有效性提供依据。方法对2008年1月至2009年12月收治的165例住院高危早产儿的临床资料进行分析。以68例作为治疗组进行静脉营养支持，其中7～14d的29例为TPN〉1周组，14～28d的28例为TPN〉2周组。对照组97例未行静脉营养，进行微量喂养。比较静脉营养对体质量增长的影响，静脉营养并发症观察，TPN〉1周组与TPN〉2周组肝功能变化。结果①在积极治疗原发病基础上，TPN使早产儿体质量有明显提高。②本研究TPN不良反应有总胆汁酸升高50例，占73．52％，并随静脉营养时间延长而逐步升高。③TPN〉1周组血清胆汁酸、总胆红素、结合胆红素水平较正常对照组均有明显增高（P〈0．05），TPN〉2周组上述指标有进一步升高（P〈0．05）。各实验组间丙氨酸氨基转移酶、碱性磷酸酶、总蛋白、白蛋白比较差异无统计学意义（P〉0．05）。结论早产儿全静脉营养有其有利的、不可替代的一面，但随着时间的延长，其并发症越来越明显，而早期早产儿能耐受的微量喂养可减少TPN的并发症的发生几率。Objective To provide evidence for safety and efficiency of critical neonates with total parenteral nutrition（TPN） support. Methods The data of 165 cases of high risk premature infants treated in municipal hospital of zaozhuang from January 2008 to December 2009 were analyzed. Sixtyeight cases in the treatment group were given intravenous nutrition. Among them, 29 cases of 7-14 days were in the group of TPN 〉 one week, 28 cases of 14-28 days were in the group of TPN above two weeks. Ninety-seven patients in the control group were given the minimal feeding, without intravenous nutrition. The effect of intravenous nutrition on weight increase, the complications and the liver function of the TPN 〉 one week group and TPN 〉 two weeks group were compared. Results （1）TPN can imcrease the weight of premature infants on the basis of treating the primary disease. （2）Total bile acid（TBA） increased in 50 cases, accounting for 73.52% of TPN complications. And it increased with the intravenous nutrition time increased. （3）There were significant differences between the group of TPN 〉 one week and the control group in the serum bile acid, serum total bilirubin and serum conjugated bilirubin （P 〈 0. 05）. The results were more higher in the group of TPN 〉 two weeks （P 〈 0. 05）. There were no significant differences between the two groups in ALT, AKP, total protein and albumin levels （P 〉 0. 05 ）. Conclusions Total parenteral nutrition is beneficical to premature infants. But with the time increased, the complications are more and more obviouse. The minimal feeding can reduce the rate of the complications of TPN.

关 键 词：早产儿 全胃肠外营养 微量喂养 胆汁瘀积 

分 类 号：R722.6[医药卫生—儿科]