静脉内营养对早产儿生长发育、血液生化及早期神经行为的影响

Effect of Parenteral Nutrition on Nutritional States, Blood Biochemistry and Neurological Behavioral in Premature Infants

目的 探讨静脉内营养对早产儿营养状况、血液生化和早期神经行为发育的影响。方法 观察 3 6例经静脉内营养支持的早产儿的体重变化、血电解质、血糖、肝功能、肾功能、血脂水平和胎龄矫正至 40周时的新生儿行为神经测定 (NBNA)结果 ,并与 3 1例未行静脉内营养支持的早产儿进行对照分析。结果 观察组生理性体重下降时间明显短于对照组 ,体重日增长量明显高于对照组 ,体重达到出院标准的时间明显短于对照组 ;对照组钾、钠、氯紊乱及低血糖的发生率高于观察组 ,但观察组高血糖和低血钙的发生率则高于对照组 ;观察组的血清前蛋白、白蛋白和球蛋白水平明显高于对照组 ,两组肝、肾功能及血脂水平无明显异常 ,但观察组直接胆红素和谷氨酰转肽酶的水平明显高于对照组 ;矫正胎龄 40周时NBNA的总评分 <3 5分者在观察组占 13 .9%( 5 3 6) ,在对照组占 48.4%( 15 3 1) ,差异极其显著。结论 静脉内营养能改善早产儿的营养状况 ,促进神经行为的发育 。

Objective To study the effect of parenteral nutrition on weight, blood biochemistry and early neurological behavioral in premature infants.Methods The nutritional states, blood electrolyte, blood sugar,hepatic function, renal function, blood lipid and Neonatal Behavioral Neurological Assessment (NBNA) at remedied 40 weeks of gestational age were examined in 36 premature infants with parenteral nutrition as the obviation group, and compared with those in 31 parenteral nutrition without parenteral nutrition as the control group. Results The days when the obviation group lost weight were shorter than the days whcn the control group, the obviation group grained weight were higher than the control group every day. The days when the weight reached the criterion discharged from hospital in the obviation group were also shorter than in the control group. The proportion of blood potassium, sodium and chloride disorder, and low blood sugar was higher in the control group than in the obviation group, but the proportion of higher blood sugar and low blood calcium was higher in the obviation group than in the control group. The serum albumin and immunoglobulin levels were higher in the obviation group than in the control group. The hepatic function, renal function and blood lipid levels had no notable abnormalities in two groups, whereas the direct billirubin and r-glutamyltransferase levels of obviation group were higher than those of control group. At remedied 40 weeks of gestational age, the cases whose total scores of NBNA were lower than 35 were 13.9% (5/36) in the obviation group,and 48.4%(15/31) in the control group. There wre significantly different between two groups.Conclusions The parenteral nutrition may improve the premature infants' nutrition states and promote the behavior development. But the blood electrolyte disorder and blood sugar change must be observed and the stasis of bile is avoided as fully as possible.