全营养混合液静脉营养支持在新生儿外科的应用

The periphery intravenous application of total nutrient admixture(TNA)in neonatal surgery

目的:介绍新生儿周围静脉用全营养混合液的配制和在围手术期的应用。方法:1993～1995年58例新生儿和未成熟儿围手术期用全营养混合液(TNA)行静脉营养支持。介绍 TNA的配方设计,配制步骤,应用方法,监测指标,溶液稳定性和治疗效果。本配方含总热量74～83kcal 309～347kj(74～83kcal)·kg^(-1)·d^(-1),氮热比(N/Q)=1:197～220,脂肪供热占非蛋白热量42%～49%。结果:本配方使用安全、有效,可明显改善新生儿围手术期营养状况和氨基酸代谢。治疗后一周体重、淋巴细胞总数、血清总必需氨基酸和总非必需氨基酸明显升高(P<0.01,t 检验)。结论:本配方 TNA 的优点是配制方便,使用安全、有效,适用于新生儿和未成熟儿围手术期经周围静脉的胃肠外营养支持。

Objective:To introduce the preparation and application of total nutrient admixture (TNA)for perioperative nutrition in neonatal surgery.Methods:Perioperative TNA was given to 58 neonates and prematures from January 1993 to December 1995.The formula,preparation ap- plication,and monitoring of stability and effect of the TNA were studied.The total caloric value of TNA was 309-347kJ(74-83 kcal)·kg^(-1)·d^(-1),N/Q=1:197-220,The fat emulsion supplied for 42%-49% of nonprotein calories.Results:The application of TNA is helpful to improve the general nutrition and serum amino acids balance.The body weighyt,total lymphocyte count, serum concentration of TEAA and TNEAA increased significantly(P<0.01)in 7 days after the application of TNA.Conclusions:TNA is safe and easy to prepare and suitable for in neonatal surgery.