【摘要】 目的观察早产儿早期两种胃肠外营养(PN)方法的临床疗效。方法回顾性总结2012年1月-2013年12月入住我院NICU的不能耐受完全胃肠道喂养的低出生体重48例早产儿临床资料。2012年1月-12月入院的早产低出生体重儿24例为对照组,按传统胃肠外营养方法生后48~72 h内给予氨基酸,72 h后给予脂肪乳,剂量均自0.5 g·kg-1·d-1开始,每日增加0.5 g/kg,直至3.5 g·kg-1·d-1。2013年1月-12月入院的早产低出生体重儿24例为观察组,生后24 h内给予氨基酸,剂量从2.5 g·kg-1·d-1开始,每日增加0.5 g/kg,第3天达3.5 g·kg-1·d-1,48 h内给予脂肪乳,剂量自1.0 g·kg-1·d-1开始,每日增加1.0 g/kg,第4天达3.0 g·kg-1·d-1。比较2组患儿各营养指标,血生化改变,观察并发症发生情况。结果观察组体重下降幅度、恢复至出生时体重时间、过渡到全胃肠道营养时间、平均住院天数均短于对照组,差异有统计学意义(P<0.01)。血糖、胆红素、胆汁淤积症及宫外生长发育迟缓(EUGR)等并发症发生情况,2组比较差异无统计学意义(P>0.05)。结论早产低出生体重儿早期采用胃肠外营养体重增长快,可以避免早产儿早期营养不良的发生,促进生长,不会增加胃肠外营养相关性并发症发生。更多还原

【Abstract】 Objective To explore the clinical effect of two types of early parenteral nutrition( PN) measures for preterm infant. Methods 48 cases of low birth weight premature infants between January 2012 and December 2013 in our hospital’s NICU were retrospectively analyzed who were intolerant of complete gastrointestinal feeding. 24 cases of low birth weight premature infants between January 2012 and December 2012 were set as a control group. This group of infants was fed in a traditional method of parenteral nutrition. Amino acid was given 48 ~ 72 hours after birth,and fat emulsion was administered after 72 hours. The dose began with 0. 5 g·kg- 1·d- 1,with daily increase of 0. 5 g/kg,until 3. 5 g·kg- 1·d- 1. Another 24 cases between January 2013 and December 2013 were selected as an observation group. Amino acid was provided within 24 hours after birth,starting with 2. 5 g·kg- 1·d- 1,with daily increase of 0. 5 g/kg,until 3. 5 g·kg- 1·d- 1on the 3rd day. 48 hours afterwards fat emulsion was given,with dose beginning with 1. 0 g·kg- 1·d- 1,the daily increase of 1. 0 g/kg,until 3. 0 g·kg- 1·d- 1on the 4th day. Various nutritional indexes and blood biochemical changes of the two groups were compared and complications observed. Results There existed differences between the two groups in terms of weight decrease,time of recovery to birth weight,time of transition to full gastrointestinal nutrition and average hospitalization days. The differences were statistically significant( P < 0. 01). No statistical difference occurred in terms of complications such as blood sugar,bilirubin,cholestasis diseases and extrauterine growth restriction( EUGR)( χ2= 0. 619,P > 0. 05). Conclusion Preterm infant early parenteral nutrition support can promote weight increase,avoid early malnutrition of premature babies,and prevent related complications.更多还原