多种油脂肪乳对早产儿肠外营养相关性胆汁淤积等并发症的影响  

Effect of SMOF lipid on parenteral nutrition-associated cholestasis and other complications in premature infants

作　　者：尹迪 张华婷 李娜[1] 沈云琳[1] 蔡成[1] 龚小慧[1] 裘刚[1] 胡勇[1] Yin Di;Zhang Huating;Li Na;Shen Yunlin;Cai Cheng;Gong Xiaohui;Qiu Gang;Hu Yong(Department of Neonatology,Shanghai Children′s Hospital,Shanghai Jiao Tong University,Shanghai 200062,China)

机构地区：[1]上海市儿童医院上海交通大学附属儿童医院新生儿科,200062

出　　处：《中国小儿急救医学》2021年第10期906-909,共4页Chinese Pediatric Emergency Medicine

摘　　要：目的比较由大豆油、中链甘油三酯、橄榄油、鱼油组成的多种油脂肪乳(商品名:合文,SMOF lipid)与中长链混合型脂肪乳(商品名:力保肪宁,Lipofundin)对早产儿肠外营养相关性胆汁淤积(PNAC)发生率的影响。方法采用回顾性病例对照研究,收集2018年1月至2019年12月上海市儿童医院新生儿重症监护室出生胎龄≤34周,出生体重≤2000 g,肠外营养使用时间≥14 d的早产儿临床资料,分为SMOF lipid组与Lipofundin组,比较两组患儿PNAC、新生儿坏死性小肠结肠炎(NEC)、支气管肺发育不良(BPD)、早产儿视网膜病(ROP)、脑室周围-脑室内出血(PVH-IVH)、晚发型败血症的发生率及肝功能变化。结果SMOF lipid组患儿的PNAC发生率显著低于Lipofundin组(P=0.042);SMOF lipid组患儿的ALT、AST平均水平较Lipofundin组低(P均<0.05);SMOF lipid组患儿达到全肠道喂养时间小于Lipofundin组(P=0.005);差异均有统计学意义。两组患儿的NEC、BPD、ROP、PVH-IVH、晚发型败血症的发生率差异均无统计学意义(P均>0.05)。结论与Lipofundin相比,SMOF lipid可降低早产儿PNAC的发生率,对NEC、BPD、ROP、PVH-IVH、晚发型败血症的发生率无明显影响。Objective To compare the effect of SMOF lipids composed of soybean oil,medium chain triglycerides,olive oil,and fish oil with medium-long chain mixed fat emulsions(Lipofundin)on parenteral nutrition-associated cholestasis(PNAC)in premature infants.Methods Clinical data were collected from premature infants hospitalized in the neonatal intensive care unit of Shanghai Children′s Hospital from January 2018 to December 2019 with gestational age≤34 weeks,birth weight≤2000 g,and duration of parenteral nutrition≥14 days.They were devided into SMOF lipid group and Lipofundin group,and the incidence of PNAC,neonatal necrotizing enterocolitis(NEC),bronchopulmonary dysplasia(BPD),retinopathy of prematurity(ROP),periventricular-intraventricular hemorrhage(PVH-IVH),late-onset sepsis and liver function were compared between two groups.Results The incidence of PNAC in the SMOF lipid group was significantly lower than that in Lipofundin group(P=0.042).The average level of ALT and AST in SMOF lipid group were markedly lower than those in Lipofundin group(P<0.05).The time to reach full enteral feeding of SMOF lipid group was shorter than that of Lipofundin group(P=0.005).There was no significant difference in the incidence of NEC,BPD,ROP,PVH-IVH,and late-onset sepsis between two groups(P>0.05).Conclusion Compared with lipofundin,SMOF lipid can reduce the incidence of PNAC in premature infants,and has no significant effect on the incidence of NEC,BPD,ROP,PVH-IVH and late-onset sepsis.

关 键 词：脂肪乳 肠外营养相关性胆汁淤积 肠外营养 早产儿 

分 类 号：R722.6[医药卫生—儿科]