极低出生体重儿静脉营养支持疗法的研究  

The benefit of parenteral nutrition to very low birth weight infants

作　　者：湛月娥[1] 王丹[1] 马恒颢[1] 谢祥鳌[1] 

机构地区：[1]广东省广州军区广州总医院小儿科,510010

出　　处：《中国全科医学》2003年第6期470-471,共2页Chinese General Practice

摘　　要：目的　研究静脉营养对极低出生体重儿 (VLBWI)的作用并就VLBWI静脉营养的应用时机、主要营养成分的剂量及递增的速度进行观察。方法　 47例VLBWI随机分为两组 ,2 2例采用静脉营养者为观察组 ,各种营养成分配制成营养袋 ,用微量输液泵经外周静脉匀速输入 ,氨基酸从 0 5 0g·kg-1·d-1开始 ,每日递增 0 2 5～ 0 5 0g kg,渐增至 2 5 0 g·kg-1·d-1,脂肪乳剂由 0 5 0～ 1 0 0 g·kg-1·d-1开始 ,每日递增 0 2 5～ 0 5 0 g kg,渐增至 1 5 0～ 2 0 0 g·kg-1·d-1。 2 5例单纯使用葡萄糖者为对照组。对两组患儿的有关指标进行检测并比较。结果　 (1)观察组VLBWI的病死率 ,硬肿症、高血糖的发生率及日平均体重增加量、平均住院天数与对照组间差别均有显著性意义 (P <0 0 5 ) ;两组患儿的高胆红素血症、高血脂的发生率间差别无显著性意义 (P >0 0 5 )。 (2 )观察组 2 0例中于生后 1周内使用脂肪乳剂与 1周后使用者其高胆红素血症发生率间的差别无显著性意义 (P >0 0 5 )。 (3)两组代谢性酸中毒发生率间差别无显著性意义 (P >0 0 5 ) ,观察组中使用小儿专用氨基酸与使用普通氨基酸者其代谢性酸中毒发生率间差别无显著性意义 (P >0 0 5 )。结论　静脉营养支持疗法可促进VLBWI体重增长 ,降低死亡率 ,Objective To investigate the benefit of parenteral nutrition which was modified in using time,dose and its increase degree of complement in very low birth weight infants(VLBWI).Methods Infants with VLBWI were divided into experimental group(22 cases received parenteral nutrition)and control group(25 cases received only necessary glucose nutrition).The parenteral nutrition composed with intralipid,amino acid co,glucose,vitamins and entered the body through peripheral venous.The primary dose of amino acid co was 0.5g·kg -1·d -1,increased to 0.25～0.50g·kg -1·d -1,and final dose was 2.5g·kg -1·d -1.Intralipid increased from 0.5～1.0g·kg -1·d -1,to 0.25～0.5g·kg -1·d -1 and 1.5～2.0g·kg -1·d -1.Associated indexes were observed and compared between tow groups.Results (1)Death,sclerema neonatorum,hyperglycemia,body weight,average days in hospital in experimental group were significantly higher than those in the control group(P<0.05).There were not significant differences between two groups in hyperbilirubinemia,metabolic acid toxicosis,hyperlipemia(P>0.05).(2)Hyperbilirubinemia of using intralipid in the first week after they were born was not significant differences compared with those of one week later(P>0.05).Conclusion Parenteral nurition is useful in increasing weight,decreasing death and complications of VLBWI.

关 键 词：极低出生体重儿 静脉营养支持疗法 研究 微量输液泵 并发症 发生率 

分 类 号：R722.1[医药卫生—儿科] R459.3[医药卫生—临床医学]