摘要
目的比较肠外营养配方中不同氨基酸和脂肪乳剂的应用剂量对极低出生体质量儿(VLBWI)肠外营养代谢性并发症发生率和预后的影响。方法回顾性分析2005年1月至2014年12月收治的328例出生后72 h内开始并接受5 d以上肠外营养支持治疗的VLBWI临床资料,VLBWI根据应用肠外营养素的剂量分为低剂量组和高剂量组,比较两组并发症发生率和预后。结果 328例患儿中,204例为低剂量组,124例为高剂量组。与低剂量组相比,高剂量组VLBWI住院期间早产儿合并症发生率低,其中颅内出血发生率降低最明显;出院时宫外发育迟缓发生率低;肠外营养代谢性并发症总体发生率高,其中高血糖、电解质紊乱和胆汁淤积发生率均升高,低血糖发生率低,差异均有统计学意义(P?<?0.05)。两组之间肝损害、高胆红素血症、坏死性小肠结肠炎和早产儿视网膜病变发生率的差异无统计学意义(P?>?0.05)。结论 VLBWI可以耐受早期积极的肠外营养,减少宫外发育迟缓和早产儿合并症。
Objective To compare the effects of different doses of amino acids and fat emulsions in parenteral nutrition on the incidence of complications and prognosis in very low birth weight infants（VLBWI）. Methods The clinical data of 328 VLBWI who received nutrition support therapy for at least 5 days starting in 72 h after birth during January 2005 to December 2014, were retrospectively analyzed. According to the dosage in parenteral nutrition, patients were divided into low-dose group and high-dose group. The incidence of complications and prognosis between two groups were compared. Results There were 204 cases in low-dose group and 124 cases in high-dose group. Compared with the low-dose group, the incidence of complications was lower in high-dose group during hospitalization and the incidence of intracranial hemorrhage was reduced most; the incidence of developmental retardation was lower at discharge; the overall incidence of metabolic complications of parenteral nutrition was higher, among which the incidence of high blood glucose, electrolyte disturbance and cholestasis were increased and the incidence of hypoglycemia was lower, and the differences were all statistically significant（P〈0.05）. There was no difference in the incidences of hepatic lesion, hyperbilirubinemia, necrotizing enterocolitis and retinopathy of prematurity between two groups（P〉0.05）. Conclutsions VLBWI can tolerate early aggressive parenteral nutrition which can reduce the incidence of extrauterine growth retardation and premature complications.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2016年第9期657-660,共4页
Journal of Clinical Pediatrics
关键词
极低出生体质量儿
肠外营养
并发症
宫外发育迟缓
very low birth weight infants
parenteral nutrition
complication
extrauterine growth retardation
