极低体重儿早期静脉营养及体质量增长状况的临床研究

The clinical study of early parenteral nutrition and weight gain in very low brith infants

目的探讨极低体重儿(VLBWL)早期静脉营养的耐受及体质量增长情况。方法对2005年1月～2010年1月本院新生儿重症监护病房收治的VLBWL进行回顾分析。其中2005年1月～2007年12月为A组40例,2008年1月～2010年1月为B组58例。结果 A、B组在开奶时间分别(68.5±24.1)h和(31.7±12.5)h、差异有统计学意义(P<0.05);B组在恢复出生体质量日龄(12.8±5.1)d、开始胃肠外营养日龄(3.8±2.9)d、第1周摄入热量(52.7±11.8)kcal/(kg.d)方面均优于A组,差异有统计学意义(P<0.05);多元逐步回归分析显示:胎龄、开奶时间、胃肠内热量是影响体质量增长的相关性因素(P<0.05);A组和B组在生后第1天、第4天、第7天血糖、血脂、血清胆红素、血肌酐及尿素氮、碳酸氢根等方面比较差异无统计学意义。结论极低体重儿(VLBWL)早期可以耐受较大剂量静脉营养,以达到最佳营养状态。

Objective To study the status of biochemical tolerance of early parenteral nutrition and weight gain in very low brith infants （VLBWL）.Methods All of 98 cases of VLBWL in NICU of author′s hospital from January 2005 to January 2010 were included in this study and their clinical data were analyzed retrospectively.Based on the tate of admission,40 of them admitted before December 2007 were divided into group A and 58 admitted after January 2008 were divided into group B.Results The age of starting enteral feeding of infants in group B （31.7±12.5）h were less than in group A（68.5±24.1）h.the difference was statistically significant （P0.05）;The age of regaining birth weight（14.3±6.1）d,beginning parenteral nutrition （3.8±2.9）d,and intestinal energy （52.7±11.8）kcal/（kg·d） in the first week after birth were significantly highter in group B.the difference were statistically significant（P0.05）;The result of Logistic regression showed affecting factors of weight gaining of infants were gestation age,starting time of feeding and intestinal energy.There were no statistic significant differences in the safetyindices of tital billrubin,glutamate-pyruvate-transaminase,blood-urea,nitrogen,creatinine,bicarbonate and glucose between two groups.Conclusion The early parenteral nutrition supply of high dosage Amion Acids and Intralipid Could be tolerated in VLBWLs,only thus can attain the best aim of their growth.