摘要
目的 评价早期应用不同剂量脂肪乳对早产/低出生体质量儿生长及肝功能的影响。方法 随机将68例早产/低出生体质量儿分为干预组38例、对照组30例，两组新生儿均在生后12-24h内给予中/长链脂肪乳 （LCT/MCT）、氨基酸、葡萄糖等治疗，辅以非营养性吸吮和微量喂养。干预组新生儿输注中/长链脂肪乳从2.0g/（kg·d） 始，以0.5g/（kg·d）递增，逐渐增至3.0g/（kg·d）；对照组中长链脂肪乳从0.5g/（kg·d） 始，以0.5g/（kg·d） 递增，逐渐增至3.0g/（kg·d）。监测两组新生儿的体质量增长情况，检测比较两组新生儿入院时以及治疗7d时的血清总胆红素、直接胆红素、丙氨酸氨基转移酶、总胆固醇、三酰甘油及血糖等指标。结果 干预组新生儿恢复出生体质量时间为 （4.52±0.92）d，短于对照组的 （6.50±2.46）d，差异有统计学意义 （P〈0.05）；干预组新生儿恢复出生体质量后体质量增长为 （28.73±2.52）g/d，高于对照组的 （17.63±2.25）g/d，差异也有统计学意义。两组新生儿治疗前以及治疗第7天的血清总胆红素、直接胆红素、丙氨酸氨基转移酶、总胆固醇、三酰甘油、血糖等差异均无统计学意义 （P〉0.05）；但干预组新生儿血清胆红素的最高值为 （201.39±16.31） μmol/L，低于对照组的 （220.40±15.35） μmol/L，差异有统计学意义 （P〈0.05）；干预组新生儿达到胆红素最高值的日龄为 （3.65±1.12）d，也小于对照组的 （4.73±1.17）d，差异也有统计学意义 （P〈0.05）。结论 早期大量应用中/长链脂肪乳有利于改善早产/低出生体质量儿的早期营养状况，缩短住院时间，临床应用安全有效。
Objective To evaluate the impact of early application of different doses of fat emulsion on the growth and liver function of premature/low birth weight infant. Methods Sixty-eight cases of premature/low birth weight infants were randomly divided into intervention group （38 cases） and the control group （30 cases）. Medium and long chain fat emulsion （LCT/MCT）, amino acids and glucose complemented with non-nutritive sucking and feeding were given to two groups 12-24 hours after birth. The intervention group was infused with the medium and long chain fat emulsion at 2.0 g/（kg.d） with daily increment of 0.5 g/（kg.d） up to 3.0 g/（kg.d）. The control group was infused with the medium and long chain fat emulsion at 0.5 g/（kg.d） with daily increment of 0.5 g/（kgd） up to 3.0 g/（kg.d）. Neonatal body weight growth was monitored. Serum total bilirubin, direct bilirubin, alanine aminotransferase, total cholesterol, triglyceridc and blood glucose were measured and compared between the two groups at admission and 7 days after treatment. Results The recovery time of the birth weight was （4.52 ± 0.92） d in the intervention group, significantly shorter than that in the control group （6.50 ± 2.46） d （P〈0.05）. Daily body weight growth was （28.73 ± 2.52） g after birth weight recovery in the intervention group, significantly higher than that of the control group （17.63 ± 2.25） g. The difference before and after treatment in serum total bilimbin, direct bilirubin, alanine aminotransferase, total cholesterol, triglyceride and blood glucose were not statistically significant （P〉0.05）. The highest neonatal serum bilirubin of intervention group was （201.39 ± 16.31 ）μmol/L, significantly lower than that of the control group （220.40 ± 15.35） μmol/L （P〈0.05）. The intervention group reached the highest bilimbin level in （3.65 ± 1.12） d, significantly shoter than the control group （4.73 ± 1.17） d （P〈0.05）. Conclusions Early application of large doses of medium and long chain fat emulsion isbeneficial in improvement of early nutritional status of preterm/low birth weight infants. It can shorten the time of hospitalizationand its clinical use is safe and effective.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2012年第9期824-827,共4页
Journal of Clinical Pediatrics
关键词
静脉营养
体质量
肝功能
早产儿
parenteral nutrition
body weight
liver function
premature infant
