摘要
目的探讨早期胃肠内微量喂养对早产儿长期胃肠外营养(PN)相关性胆汁淤积(PNAC)的防治作用。方法对2008年1月-2009年12月在本院NICU接受PN≥14d的94例早产儿进行临床分析。选取2008年收治的49例早产儿作为对照组。2009年收治的45例早产儿为干预组,增加早期胃肠内微量喂养作为干预措施。比较二组PNAC发生率、胆汁淤积程度、PNAC危险因素的差异。计数资料比较采用χ2检验,计量资料比较采用t检验,P<0.05为差异有统计学意义。结果干预组、对照组早产儿PNAC发生率分别为17.78%和14.28%,二者比较差异无统计学意义。干预组PNAC患儿血清结合胆红素、总胆汁酸水平较对照组降低,但差异均无统计学意义。干预组禁食时间、PN持续时间、达到全胃肠内营养时间、氨基酸累积用量均较对照组降低,差异均有统计学意义(Pa<0.05)。结论早期胃肠内微量喂养可降低早产儿PNAC的危险因素,但未能降低早产儿PNAC的发生率。防治早产儿PNAC应采取综合措施。
Objective To explore the preventive effect of early minim enteral feeding on parenteral nutrition（PN）associated cholestasis（PNAC）in premature infants.Methods From Jan.2008 to Dec.2009,94 premature infants were given PN for 14 days or more at the Newborn Intensive Care Unit in Nanfang Hospital,and their clinical data were analyzed.The 45 cases of premature infants receiving minim enteral feeding early as intervention measure in 2009 were regarded early as intervention group;the 49 cases of premature infants in 2008 were selec-ted as control group.The differences of the incidence of PNAC,the degree of cholestasis and the risk factors of PNAC between intervention group and control group were compared.Measurement data were analyzed by using two independent samples t test.Count data were analyzed by using Chi-square test.P0.05 was considered to have statistical significance.Results The incidence of PNAC in intervention group was 17.78%,while that in the control group was 14.28%,and no significant difference was found between 2 groups.In intervention group,serum direct bilirubin,total bile acids were lower than those in control group,but the differences had no statistical significance.Fasting time,PN duration,time to full enteral nutrition,the cumulative amount of amino acids in intervention group decreased significantly compared with those in control group（Pa0.05）.Conclusions Early minim enteral feeding can reduce the risk factors of PNAC in premature infants,but failed to reduce the incidence of PNAC in premature infant.Comprehensive measurement may be adopted to prevent PNAC in premature infants.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2010年第19期1473-1474,1476,共3页
Journal of Applied Clinical Pediatrics
