不同热氮配方的肠外营养在低体重早产儿中的应用比较  

Comparison of parenteral nutrition with different hot nitrogen formulas in underweight premature infants

作　　者：李猛[1] 梁桂珍[1] 朱刚[1] 

机构地区：[1]佛山市第一人民医院,广东佛山528000

出　　处：《热带医学杂志》2013年第8期982-984,共3页Journal of Tropical Medicine

摘　　要：目的比较不同热氮配方肠外营养(PN)在早产儿中的应用效果。方法对2008年1月至2010年12月入住本院新生儿病区(胎龄为27～36周、体重为0.9～1.60kg)、应用肠外营养(parenteral nutrition,PN)2周以上的低体重早产儿74例进行回顾分析,按照实施PN热氮的高低分为高热氮组(36例)、低热氮组(38例),两组均于生后12～24h应用PN,分别比较两组患儿体重下降幅度、恢复至出生体重时间、恢复出生体重后日平均增长值、PN使用时间、过渡到全肠内营养(enteral nutrition,EN)的时间、住院天数以及静脉炎、肝损害、高血糖、高脂血症、呼吸暂停的发生率。结果低热氮组PN使用时间、过渡到全EN的时间及静脉炎、肝损害、高血糖、高脂血症、呼吸暂停的发生率均小于高热氮组,差异有统计学意义(P<0.05);而患儿体重下降幅度、恢复至出生体重时间大于高热氮组,差异有统计学意义(P<0.05);恢复出生体重后的日平均增长值、住院天数两组差异无统计学意义(P>0.05)。结论低热氮PN有利于患儿早期过渡到全EN、PN的使用时间短,静脉炎、肝损害、高血糖、高脂血症及呼吸暂停的发生率低;而高热氮PN患儿体重下降幅度小,恢复至出生体重的时间少。本研究提示临床应综合考虑患儿个体情况,选择适合的PN支持方式。Objective To compare application effects of parenteral nutrition （PN） with different hot nitrogen formulas in premature infants.Methods Cases of 74 underweight premature infants under more than two weeks PN application with the gestational age of 27-36 weeks and weight of 0.9-1.60 kg that came to neonate inpatient area of the hospital were reviewed and analyzed from January 2008 to December 2010,they were divided into high nitrogen group （36 cases）and low nitrogen group （36 cases）according to the procedure of high and low nitrogen.PN was applied 12-24 h after birth in both groups.Comparison was done in weight falling range,time for recovering to birth weight,daily average growth value after recovering to birth weight,service time of PN,time for transition to total EN,hospital stay and hyperglycemia,hyperlipoidemia,hepatic lesion,phlebitis,and apnea syndrome between the two groups.Results Service time of PN,time for transition to total enteral nutrition （EN）,occurrence rate of hyperglycemia,hyperlipoidemia,hepatic lesion,phlebitis and apnea syndrome in the low nitrogen group were lower and shorter than the high nitrogen group,the differences had statistical significance （P＆lt;0.05）;while weight falling range and time for recovering to birth weight in low nitrogen group were longer and higher than the high nitrogen group,the differences had statistical significance （P ＆lt;0.05）;it was no statistical differences in terms of daily average growth value after recovering to birth weight and hospital stay in the two groups （P＆gt;0.05）.Conclusions Low nitrogen PN is good for sick infants to transit to total EN at early stages.It shortens the use time of PN and reduces the occurrence rate of hyperglycemia,hyperlipoidemia,hepatic lesion,phlebitis,and apnea syndrome,while high nitrogen PN reduces the rate of weight loss of recovering to birth weight in sick infants.The study suggests that clinical shoud consider the sick infants’ individual situation and choose the correct PN support.

关 键 词：早产儿 肠外营养 肠内营养 并发症 

分 类 号：R459.3[医药卫生—治疗学]