肠外营养在新生儿短肠综合征治疗中的作用  

Effect of parenteral nutrition on neonatal short bowel syndrome

作　　者：蔡威[1] 汤庆娅[2] 于黎华[2] 冯一[2] 夏韶民[2] 陶晔璇[2] 施诚仁[1] 

机构地区：[1]上海第二医科大学附属新华医院上海儿童医学中心小儿外科,200092 [2]上海第二医科大学附属新华医院临床营养中心,200092

出　　处：《中华小儿外科杂志》2003年第3期227-229,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的　探讨肠外营养对新生儿短肠综合征 (SBS)患儿治疗的作用。方法　回顾总结1988～ 2 0 0 1年在我院PN支持治疗的 9例新生儿短肠综合征 ,观察PN开始时对患儿生长的影响及PN相关并发症。结果　 9例长期随访中 8例存活 ,1例放弃治疗后死亡。4例出现并发症 ,严重低钙1例 ,血尿、右肾结石 1例 ,胆汁淤积 1例 ,贫血 1例 ,经治疗后痊愈。PN开始迟的 2例 ,第 1个月体重下降明显。PN开始早的 7例 ,3例伴CMV感染者生后 3个月内体重增加较非感染组缓慢 ,两组比较有显著性差异 (t=5 .78,P =0 .0 0 2 )。结论　SBS患儿应早期营养支持。SBS患儿伴CMV感染将严重影响体重增加。SBS患儿PN治疗期间并发症出现率较高 ,应予高度重视。Objective To evaluate the effect of parenteral nutrition (PN) on neonatal short bowel syndrome (SBS).Methods The relation between PN support and weight gain of 9 infants with SBS treated from 1988 to 2001 were reviewed. The main diagnosis was intestinal atresia (5), midgut volvulus (1), neonatal enterocolitis (2) and gastroschisis (1). The mean length of remained bowel was 67cm (45～105?cm). The duration of follow up ranged from 1.2 to 13years (mean 5.1 years).Results Of them, 8 cases survived and one died after the therapy terminated. Four of 9 infants had PN associated complications including one severe hypocalcemia, one right kidney stone, one PN associated cholestasis and one anemia. All cases were recovered with appropriate treatments. The weight loss was obvious in 2 cases who didn't accepted PN support until 3 weeks after operation. Seven newborns started PN within 1 week postoperatively. Three of them with CMV infection had less weight gain in the first 3 months. The mean weight gain rate in the first 3 months was significant higher in infants without CMV infection than those with CMV infection ( 41.4 ± 9.0% vs 3.9 ± 7.6% , P = 0.002 ). Conclusions The SBS infants should be given PN support as early as possible post operatively. The CMV infection has significant impact the weight gain in SBS infants. The special attention should be paid to the PN complications which could be reversed by early treatments.

关 键 词：新生儿 短肠综合征 肠外营养 CMV感染 

分 类 号：R726.5[医药卫生—儿科]