多种油脂肪乳致新生儿乳酸酸中毒和(或)血小板减少两例并文献复习  

Neonatal lactic acidosis and/or thrombocytopenia caused by multi-oil fat emulsion injection:two cases report and literature

作　　者：林娟 施欣[1] 刘利婷 谭茵莉 韦锦焕[2] 唐新意[1] Lin Juan;Shi Xin;Liu Liting;Tan Yinli;Wei Jinhuan;Tang Xinyi(Department of Pediatrics,the Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院儿科,广州510630 [2]中山大学附属第一医院泌尿外科,广州510080

出　　处：《新医学》2023年第8期580-584,共5页Journal of New Medicine

基　　金：国家自然科学基金(81602219)。

摘　　要：目的分析多种油脂肪乳(SMOF)诱发的新生儿乳酸酸中毒、血小板减少的临床特点,提高临床医师对该药不良反应的认识水平。方法分析在使用静脉多种油脂肪乳大于2周时出现乳酸酸中毒和(或)血小板减少的2例男性新生儿的临床资料,并以“新生儿”“多种油脂肪乳”“乳酸酸中毒”“血小板减少”(包括中英文)为检索词,对以下数据库的相关文献进行检索:PubMed、中国生物医学文献服务系统(SinoMed)、CNKI、万方数据知识服务平台、中华医学期刊全文数据库,收集并分析检索到的病例资料。结果2例患儿停用SMOF后血乳酸水平、血小板计数恢复正常,酸中毒被纠正。检索文献收集到脂肪乳注射液导致脂肪超载综合征病例8例,其中1例使用SMOF,均于停用静脉脂肪乳后好转,其中4例同时予换血治疗。结论SMOF可致新生儿乳酸酸中毒和(或)血小板减少,临床医师应注意提高对其不良反应的认识水平,降低误诊率与误治率。Objective To analyze the clinical characteristics of neonatal lactic acidosis and thrombocytopenia induced by multi-oil fat emulsions(SMOF),aiming to deepen clinicians’understanding of adverse reactions to this drug.Methods Clinical data of two male neonates who suffered from lactic acidosis and/or thrombocytopenia after using intravenous SMOF for more than two weeks were analyzed.Literature review was conduced from PubMed,SinoMed,CNKI,Wanfang Data and CMAPH using the keywords of“neonate”,“multi-oil fat emulsions”,“lactic acidosis”,and“thrombocytopenia”in both Chinese and English.Clinical data of retrieved cases were collected and analyzed.Results Blood lactate,acidosis,and platelets returned to normal in two cases after terminating SMOF.Eight cases of fat overload syndrome caused by fat emulsion injection were retrieved by literature review,and one of them was treated with SMOF.All eight cases were improved after terminating intravenous fat emulsion,and four of them also received blood exchange therapy.Conclusions SMOF can cause neonatal lactic acidosis and/or thrombocytopenia.Clinicians should deepen the understanding of adverse reactions to this drug and lower the misdiagnosis and mistherapy rates.

关 键 词：新生儿 多种油脂肪乳 乳酸酸中毒 血小板减少 

分 类 号：R722.1[医药卫生—儿科]