不同剂量脂肪乳剂对危重早产儿血气的影响

Effect of fat emulsion on arterial blood gas in critically ill premature infants

目的：观察脂肪乳剂对危重早产儿动脉血气的影响。方法：将４０例患有肺炎等疾病的危重早产儿随机分成四组，其中１组不给予脂肪乳剂作为对照，另３组分别按每天每千克体重给予１０％Ｉｎｔｒａｌｉｐｉｄ１、２和３ｇ，连续５天。在实验前和结束时分别作血脂测定和动脉血气分析。结果：动脉血气分析示各组实验后与实验前比较无显著差异，应用脂肪乳剂１．０、２．０、３．０ｇ／（ｋｇ·ｄ）后各实验组与对照组比较差异亦不显著，仅在３．０ｇ／（ｋｇ·ｄ）组显示ＰａＯ２和ＳａＯ２有下降的趋势。血脂分析示仅在实验后３．０ｇ／（ｋｇ·ｄ）组总胆固醇比实验前显著增高，甘油三酯显著高于对照组。结论：在危重早产儿应用脂肪乳剂１～３ｇ／（ｋｇ·ｄ）对血气无显著影响，但仍提出在危重早产儿应用脂肪乳剂时仍应注意监测肺功能有关指标，如动脉血气分析。

Objectives:To observe the effect of fat emulsion on the blood gas analysis in critically ill premature infants. Methods:Forty cases of premature neonates were randomly divided into 4 groups, receiving the fat emulsion of 10% Intralipid respectively at the dose of 0,1,2 and 3 g/(kg·d) for 5 days.Blood gas analysis was made and serum level of cholesterol and triglyceride were measured before and after the observation period. Results:No significant change in PaO 2,SaO 2 and PaCO 2 was found in every group and no significant difference between the group of 1,2 or 3 g/(kg·d) and the group of 0 g/(kg·d).But PaO 2 and SaO 2 appeared to be lowest in the group of 3 g/(kg·d).The level of cholesterol was increased significantly after the infusion of 3 g/(kg·d) of fat emulsion and the level of triglyceride in the group of 3 g/(kg·d) was significantly higher when compared with that in the group of 0 g/(kg·d). Conclusions:The use of fat emulsion at the dose of 1￣3 g/(kg·d) does not affect the blood gas in critically ill premature infants.