肠外营养方式对极低出生体重儿消化功能及肝脏功能影响

Parenteral nutrition on digestive function and liver function in very low birth weight infants

[目的]探讨肠外营养支持应用在极低出生体重儿中对消化功能和肝脏功能的影响及临床价值探讨。[方法]将我院治疗的极低出生体重儿采用随机数字法分为观察组和对照组,每组各68例,对照组给予延迟微量胃肠外营养支持,观察组给予早期胃肠外营养支持,对比2组患儿消化功能和肝脏功能变化情况。[结果]观察组患儿体重增加(27.86±5.49)g/d,住院时间(12.53±1.32)d,转全量胃肠道喂养时间(8.31±1.13)d,宫外生长发育迟缓率4.41%;对照组患儿体重增加(22.16±1.84)g/d,住院时间(18.69±2.79)d,转全量胃肠道喂养时间(13.25±2.85)d,宫外生长发育迟缓率16.18%,组间对比差异有统计学意义。观察组患儿出生后7d氨基酸(3.97±1.93)g·kg^(-1)·d^(-1),白蛋白(35.49±3.65)g/L,前白蛋白(99.69±13.54)mg/L;对照组患儿出生后7d氨基酸(2.44±1.01)g·kg^(-1)·d^(-1),白蛋白(32.04±2.38)g/L,前白蛋白(90.04±8.72)mg/L,组间对比差异有统计学意义(P<0.05)。观察组出生后7dTBIL(12.13±2.35)mg/dl,IBIL(9.13±1.24)mg/dl,DBIL(1.50±0.53)mg/dl;对照组出生后7dTBIL(14.66±4.31)mg/dl,IBIL(11.87±2.89)mg/dl,DBIL(1.54±0.55)mg/dl;其中TBIL和IBIL组间对比差异有统计学意义。[结论]早期胃肠外营养支持应用在极低出生体重儿中能够改善患儿营养状况,减轻患儿肝脏损伤程度,缩短治疗时间,值得在临床上推广应用。

[Objective]To discuss the effect of digestive function and liver function with the application of parenteral nutrition support in very low birth weight infants.[Methods]With the random number method,very low birth weight infants from our hospital were divided into observation group and control group（n=68in each group）.Control group was given delayed parenteral nutrition support,and the observation group was given early parenteral nutrition support.The function changes of digestive and liver were compared between children of the two groups.[Results]Children in the observation group were found with weight gain（27.86±5.49）g/d,length of hospital stay（12.53±1.32）d,transfer full amount of the gastrointestinal tract feeding time（8.31±1.13）d,palace growth delay rate 4.41%,while in the control group with weight gain（22.16±1.84）g/d,length of hospital stay（18.69±2.79）d,transfer full amount of the gastrointestinal tract feeding time（13.25±2.85）d,palace growth delay rate 16.18%,and the differences between which was statistically significant.After born 7d,observation group children were found with amino acids（3.97±1.93）g·kg^-1·d^-1,albumin（35.49±3.65）g/L,prealbumin（99.69±3.54）mg/L,and control group children with amino acids（2.44±1.01）g·kg^-1·d^-1,albumin（32.04±2.38）g/L,prealbumin（90.04±8.72）mg/L,and the differences between which was statistically significant.（P〈0.05）.After born 7d,observation group was found with TBIL（12.13±2.35）mg/dl,IBIL（9.13±1.24）mg/dl,DBIL（1.50±0.53）mg/dl,while that in the control group was（14.66±4.31）mg/dl,（11.87±2.89）mg/dl,DBIL（1.54±0.55）mg/dl and the difference of TBIL and IBIL between two groups was statistically significant.[Conclusion]The application of early parenteral nutrition support in very low birth weight can improve nutritional status of children and release the liver damage,shorten the treatment time,and is worthy of popularization and application in clinic.