脂肪乳在早产儿黄疸静脉营养中的应用探讨  

Application of Fat Emulsion in Intravenous Nutrition for Premature Infants with Jaundice

作　　者：魏恩焕[1] 杨惠[1] 黄建明[1] 许凤銮[1] 

机构地区：[1]福建医科大学附属三明第一医院,福建三明365000

出　　处：《儿科药学杂志》2014年第2期10-12,共3页Journal of Pediatric Pharmacy

基　　金：三明市科技局科研项目;明财(教)指[2007]60号(2007-L-1)

摘　　要：目的:探讨胆红素>170μmol/L的早产儿在静脉营养时对脂肪乳的耐受性。方法:我院新生儿科收治的血清胆红素峰值均>170μmol/L,体质量<2 500 g,孕周<37周,不能经口喂养的早产低体质量儿100例,随机分为观察组和对照组各50例。观察组按早产儿管理指南能量要求逐日增加脂肪乳用量,对照组胆红素>170μmol/L时限制脂肪乳用量为1 g/kg,两组患儿均进行光疗。分别于生后第1天、第3天、第5天、第7天、第10天观察两组患儿血清总胆红素、直接胆红素、血脂指标,对两组患儿体质量变化情况及低血糖发生率进行比较。结果:两组血清总胆红素、直接胆红素及血清胆固醇在第1天、第3天、第10天比较,差异均无统计学意义(P>0.05)。血清甘油三酯在第5天、第7天时两组比较差异有统计学意义(P<0.05)。观察组体质量下降幅度较对照组低,恢复至出生体质量日龄明显缩短,观察组患儿低血糖发生率明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论:出现黄疸的早产儿在及时光疗情况下不应限制脂肪乳用量。Objective： To investigate the tolerance of premature infants with bilirubin 〉170 μnol/L to fat emulsion in intravenous nutrition. Methods： One hundred patients with bilirubin 〉170 μ mol/L, weight 〈2 500 g, gestational age 〈 37 weeks and not through the mouth feed premature infant, were randomized into two groups equally. According to management guidelines of premature infants, the fat emulsion were increased day by day in the observation group. In the control group, patients received fat emulsion 1 g/kg when bilirubin 〉170 p^mol/L. Premature infants in the two groups were treated with phototherapy. Serum total bilirubin, direct bilirubin, blood lipid, weight changes and the incidence of hypoglycemia were observed and analyzed on the first, third, fifth, seventh and tenth day after birth. Results： Compared to the control group, there was no significant statistical difference in the total bilirubin, direct bilirubin and serum cholesterol on the first, third and tenth day after birth （P〉0.05）. There was a difference in serum triglycerides on the fifth and seventh day of the two groups （P〈0.05）. In the observation group the decline of weight was lower than that in the control group; the time of recovery to birth weight was significantly reduced; hypoglycemia incidence was significantly lower than that in the control group （P 〈 0.05 ）. Conclusions： Preterm infants with jaundice under phototherapy in time should not limit the use of fat emulsion.

关 键 词：早产儿 黄疸 脂肪乳 静脉营养 

分 类 号：R722.1[医药卫生—儿科]