早期应用脂肪乳对极低出生体重儿体质量增长的影响及安全性分析

Effect of early fat emulsion usage on weight increase and its clinical safety in very low birth weight infants

目的观察早期应用脂肪乳对极低出生体重儿体质量增长的影响及安全性分析。方法沈阳市妇婴医院新生儿科2012-01/2014-12收治82例极低出生体重儿,随机分为观察组42例和对照组40例。观察组于生后24h内给予脂肪乳静脉滴注,0.5~1.0g/（kg·d）开始,每日增加0.5g/kg,最大量3.0g/kg。对照组于第4天开始脂肪乳静脉滴注,方法同观察组。两组其他静脉营养方法相同。比较两组患儿体质量增长情况、出生体质量恢复时间、血生化指标和相关并发症情况。结果观察组较对照组较快开始体质量增长,较快恢复出生体质量,住院时间缩短,差异均有统计学意义（P〈0.05）;两组患儿血胆红素、转氨酶、尿素氮等指标比较差异无统计学意义（P〉0.05）;且未增加患胆汁淤积、高胆红素血症、感染、坏死性小肠结肠炎等的危险。结论生后早期应用脂肪乳能促进极低出生体重儿体质量增长,减少宫外迟缓发生,缩短住院时间,且不会引起相关并发症发生增加。

Objective To observe the safety and the effect of fat emulsion on weight increase in very low birth weight infants.Methods From January 2012 to December 2014,82 very low birth weight infants in our hospital were randomly divided（by means of random number table）into two groups：the treatment group（42persons）and the control group（40persons）.The treatment group received intravenous nutrition with fat emulsion within 24 hours after birth,the initial dose 0.5~1.0g/（kg·d）with an increase of 0.5g/kg daily;the maximum dose was 3.0g/kg every day.The control group received fat emulsion from the fourth day after birth.The other methods were the same.Compare the weight growth,the time to return to normal weight,biochemical parameters and complications.Results The daily weight gain of the treatment group was significantly higher than the control group.The time to return to normal weight in the treatment group was shorter than the control group（P〈0.05）.There were no significant differences in biochemical indicators between the two groups（P〉0.05）.The risks of cholestasis,high bilirubin,and infection were increased in the treatment group.Conclusion Administration of a larger dose of fat emulsion in early premature infants can promote the weight gain,reduce the incidence of EUGR,and shorten the hospital stay,which has no influence on the rates of complications.