营养物质对早产儿肠道外营养相关性胆汁淤积的影响

目的分析营养物质对早产儿肠道外营养相关性胆汁淤积(PNAC)的影响。方法选择在新生儿监护病房进行肠道外营养支持治疗14 d以上的早产儿136例,根据住院期间是否发生胆汁淤积分为PNAC组(56例)和非PNAC组(80例)。比较两组临床数据,Logistic回归分析影响早产儿出现PNAC的危险因素。结果非PNAC组患儿的脂肪乳热量比、氨基酸热量比、禁食时间、喂养困难率等均显著低于PNAC组(P<0.05);PNAC组患儿的总热量和乳类热量比均显著低于非PNAC组(P<0.05)。脂肪乳提供热量比率、氨基酸提供热量比率、禁食时间等均是影响早产儿出现PNAC的危险因素(P<0.05);乳类提供热量比率则是影响早产儿出现PNAC的保护因素。结论氨基酸和脂肪乳提供热量比率高、禁食时间长等因素影响早产儿发生PNAC,临床需制订相应的防治措施,降低早产儿PNAC的发生。

Objective To analyze the effect of nutrients on parenteral nutrition associated cholestasis(PNAC)in preterm infants.Methods Totally 136 cases of preterm infants treated with parenteral nutrition support for more than 14 d in neonatal care unit were selected.According to whether cholestasis occurred during hospitalization,they were divided into PNAC group(56 cases)and non-PNAC group(80 cases).The risk factors of PNAC in preterm infants were analyzed by logistic regression.Results The fat milk calorie ratio,amino acid calorie ratio,fasting time and feeding difficulty rate of children in PNAC group were significantly lower than those in PNAC group(P<0.05),the total calorie and milk calorie ratio of children in PNAC group were significantly lower than those in non PNAC group(P<0.05).The ratio of fat milk to calories,amino acid to calories and fasting time were all risk factors(P<0.05),while the ratio of milk to calories was the protective factor.Conclusion The high ratio of amino acids and fat to provide calories and the longtime of fasting affect the occurrence of PNAC in preterm infants.