肝素钠预防新生儿胃肠外营养相关性胆汁淤积疗效

Heparin sodium prevents parenteral nutrition associated cholestasis in neonates

目的探讨肝素钠预防新生儿胃肠外营养相关性胆汁淤积(PNAC)的疗效。方法对我院2014年3月~2017年3月收治的在本院应用胃肠外营养的新生儿,随机分为对照组和治疗组,依据治疗方法将这些患儿分为胃肠外静脉营养组(对照组)和胃肠外营养组联合肝素钠治疗组(观察组)两组,对两组患儿分别检测肝功能、凝血常规,并对胃肠外营养大于14d的患儿进行分析。结果对照组30例,发生胆汁淤积4例(13.3%),观察组30例,发生胆汁淤积2例(6.6%),两组差异有统计学意义(P<0.05),对照组住院时间(38.7±16.1)d,血浆DBIL(47.42±4.3)μmol/L,TBA(57.58±4.8)μmol/L,观察组住院时间(30.8±13.2)d,血浆DBIL(16.48±5.1)μmol/L,TBA(28.89±5.2)μmol/L,两组差异有统计学意义(P<0.05)。结论肝素钠可以减少新生儿PNAC的发生率,减少住院天数,未观察到药物不良反应。

Objective To investigate the e ffect of heparin sodium on prevention of neonatal parenteral nutrition associated cholestasis(PNAC).Methods Neonates treated with parenteral nutrition in our hospital from March 2014 to March 2017 were randomly divided into control group and treatment group.According to the treatment method,the children were divided into two groups:parenteral nutrition group(control group)and parenteral nutrition group combined with heparin sodium treatment group(observation group).The liver function and coagulation were detected in the two groups,and the results of parenteral nutrition were analyzed.Results In control group(n=30)cholestasis occurred in 4 cases(n=4)and in observation group(n=30)cholestasis occurred in 2 cases(P<0.05).In the control group,the hospitalization time(38.7±16.1)d,the plasma DBiL was(47.42±4.3)μmol/L,TBA was(57.58±4.8)μmol/L,the hospitalization time of the observation group was(30.8±13.2)d,the plasma DBiL was(16.48±5.1)mol/L,TBA was(28.89±5.2)mol/L,the difference between the two groups was statistically significant(P<0.05).Conclusion Heparin sodium can reduce the incidence of neonatal PNAC,reduce hospital stay,no adverse drug reactions were observed.