极低出生体重儿肠道外营养相关性胆汁淤积危险因素分析

Analysis on risk factors of parenteral nutrition-associated cholestasis in extremely low birth weight infants

目的探讨新生儿重症监护病房(neonatal intensive care unit,NICU)中极低出生体重儿(extremely low birth weight infants,ELBWI)肠道外营养相关性胆汁淤积(parenteral nutrition-associated cholestasis,PNAC)的危险因素。方法回顾NICU中229例静脉营养支持两周以上的极低出生体重儿的临床资料,比较PNAC组与非PNAC组在胎龄、出生体重等临床资料的差异。结果极低出生体重儿PNAC发生率为11.79%(27/229),PNAC组患儿胎龄、出生体重小于非PNAC组,而PN持续时间、PN热卡摄入量、脂肪乳最大剂量及累计用量、感染、贫血发生率大于非PNAC组(P<0.05)。结论低胎龄、低出生体重、PN持续时间过长、PN提供热卡过高、脂肪乳最大剂量及累计用量、感染、贫血是极低出生体重儿发生PNAC的危险因素。

objective To explore the risk factors of parenteral nutrition-associated cholestasis （PNAC） in extremely low birth weight infants（ELBWI）. Methods The clinical data of 229 ELBWI receiving parenteral nutrition （PN） for more than two weeks in neonatal intensive care unit （NICU） were retrospectively analyzed. The differences between PNAC group and non-PNAC group about gestational age,birth weight,sex,et al were compared. Results The incidence of PNAC was 11.79% （27/229）. Compared with non-PNAC group,the average gestational age and birth weight in PNAC group were lower; Average PN duration, average energy intake, the large fat milk dosage and accumulative dosage were higher;The incidence of infection and anemia in PNAC group were higher too（P〈0.05）. Conclusion The incidence of PNAC is associated with lower gestational age,lower birth weight,longer PN duration,higher energy intake,larger fat milk dosage and accumulative dosage,infection and anemia.