全静脉营养支持疗法治疗早产及危重新生儿的疗效

Clinical effect of total parenteral nutrition support therapy in the treatment of preterm labor and critically ill neonates

目的:探讨全静脉营养支持疗法治疗早产及危重新生儿的临床效果,并分析不良反应发生情况。方法:将110例早产及危重新生儿为研究对象,随机分为观察组与对照组,观察组给予全静脉营养支持治疗,对照组给予一般支持治疗。记录两组患者肝功能、血脂水平变化比较临床疗效,并分析不良反应率。结果:治疗前,两组肝功能及血脂各项指标差异均无统计学意义(P>0.05);经治疗后,对照组仅谷氨酰转移酶、甘油三酯无明显改变(P>0.05),其余指标均下降(P<0.01),而观察组中仅直接胆红素水平变化明显(P<0.01),其余各项指标均无明显变化(P>0.05)。观察组中,4例因严重肺出血而死亡,其余51例均治愈出院,治愈率为92.7%,体质量增加(17.1±9.7)g/d,住院天数为(13.1±3.5)d;对照组55例中,死亡13例,治愈42例,治愈率为76.4%,体质量增加(5.2±4.1)g/d,住院天数为(18.9±7.1)d。组间比较观察组治愈率高于对照组(χ2=4.453,P<0.05),观察组体质量增加多于对照组(t=8.38,P<0.05)、观察组体住院天数少于对照组(t=5.43,P<0.05)。结论:全静脉营养支持疗法应用于早产及危重新生儿临床救治中,临床效果肯定,患儿耐受性佳,值得推广应用。

Objective： To investigate the clinical effect of total parenteral nutrition support therapy in the treatment of premature and critical neonates,and to analyze the occurrence of adverse reactions. Methods： 110 cases of premature and critically ill neonates were randomly divided into study group and control group. The study group was given total parenteral nutrition support,and the control group was given general supportive treatment. The changes of liver function and blood lipid level were recorded in the two groups,and the clinical effects of the two groups were compared. Results： Before treatment,liver function and blood lipid indexes in the two groups had no significant difference（ P〉0. 05）; after the treatment,in the control group only glutamyltransferase（ GGT） and triglyceride（ TG） changed significantly（ P〈0. 05）,while the other indexes were significantly decreased（ P〈0. 01）,and in the study group only direct bilirubin（ DB） level changed significantly（ P〈0. 01）,while the other indexes had no significant change（ P〉0. 05）. 4 cases died due to severe pulmonary hemorrhage,51 cases cured and discharged,with the cure rate 92. 7 %,the average body mass increased（ 17. 1 ＋ 9. 7） g / d,and the average hospital stay（ 13. 1 ＋ 3. 5） d in the observation group.In the control group of 55 cases,13 cases died,and 42 cases were cured,with the cure rate 76. 4%,the average body mass increased（ 5. 2 ＋4. 1） g / d,and the average hospital stay（ 18. 9 ＋ 7. 1） d. Comparison between the two groups showed the recovery rate of the observation group was higher than that of the control group（ χ2= 4. 453,P〈0. 05）,and the body mass of the former increased more than that of the latter（ t =8. 38,P〈0. 05）. The hospital stay of the observation group was less than that of the control group（ t = 5. 43,P〈0. 05）. Conclusion： Application effect of total parenteral nutrition support therapy in the clinical treatment of premature birth and critically ill neonates is positive,worth promoting as sick neonates＇ tolerance is good.