完全胃肠外营养相关性胆汁淤积的检测指标及危险因素分析

The detection indicators and risk factors of cholestasis associated with total parenteral nutrition

目的探讨胃肠外营养相关性胆汁淤积的影响因素及检测的敏感指标,降低并发症损害。方法回顾分析完全胃肠外营养并且持续时间在5 d以上的80例患儿病例,按有无胃肠外营养相关性胆汁淤积(PNAC)分为两组,对其静脉营养液的量、持续时间及生化指标进行分析。结果 80例完全胃肠外营养的患儿中有14例存在胆汁淤积,发病率为17.5%,PNAC组肝功能及胆红素指标均高于无PNAC组,患儿体重、平均完全胃肠外营养(TPN)持续时间、PN热卡摄入量与无PNAC组相比差异具有统计学意义(P<0.05).结论 PNAC的发生与患儿TPN时间、TPN使用量、低出生体重有关,及时检测分析肝功能、胆红素代谢指标有利于早期发现PNAC,尽早干预,降低器官功能损害。

Objective To explore the detection indicators and risk factors of cholestasis associated with total paren- teral nutrition to reduce complications. Methods The data of the 80 children with total parenteral nutrition more than five days were retrospectively analyzed, according to the standard with and without parenteral nutrition associated cholestasis （PNAC） is divided into two groups. The amount of its parenteral nutrition, continuous time and biochemical was analyzed. Results 80 patients with total parenteral nutrition in children, 14 patients presented with cholestasis, the incidence rate was 17.5% , liver function and bilirubin of PNAC group were higher than non - PNAC group, compared with the non - PNAC group, the difference in body weight, the average total parenteral nutrition （TPN） duration, PN calorie intake was statistically significant （P 〈 0. 05 ）. Conclusion The occurrence of PNAC in children with prolonged TPN, more TPN and low birth weight, timely detection of sub -liver function, bilirubin metabolism in favor of early detection of PNAC, early intervention can reduce organ damage.