混合水溶性维生素对新生儿肠外营养稳定性的影响及临床疗效分析

Effect and clinical efficacy of mixed water-soluble vitamins on the stability of parenteral nutrition in newborns

目的分析两种混合水溶性维生素对新生儿肠外营养稳定性的影响及临床疗效。方法选取2018年7月至2019年7月于惠州市第一人民医院接受肠外营养液治疗的96例新生儿作为研究对象,根据使用营养液的不同分为A组(n=47,使用含抑菌剂的混合水溶性维生素)与B组(n=49,使用不含抑菌剂的混合水溶性维生素),营养液进一步分为低剂量和高剂量组。实验室检测配置48h内营养液的稳定性,统计分析治疗前后新生儿各项生长指标的变化、并发症发生情况等。结果两组不同剂量之间pH值比较,差异无统计学意义(P>0.05);两组在配制48h内pH值随着时间推移差异无统计学意义(P>0.05),pH值均稳定在5.8左右;两组同剂量之间平均乳粒粒径大小比较差异无统计学意义(P>0.05),两组在配制48h内乳粒粒径大小随着时间的推移而有所升高,差异均有统计学意义(F值分别为20.315、14.412、10.143、11.362,P<0.05),且均未超过1μm;同组不同剂量之间聚合物分散性指数(PDI)值比较差异无统计学意义(P>0.05),同剂量之间A组PDI值高于B组(P<0.05);两组在配制48h内PDI值随着时间的推移而有所升高,差异均有统计学意义(F值分别为4.730、4.833、5.541、4.550,P<0.05);在调配后48h内不溶性微粒均符合要求,且48h内细菌培养均为阴性;两组患儿营养液使用量与时间、新生儿生长情况、住院时间、并发症发生率比较,差异均无统计学意义(P>0.05);两组营养液使用后生化指标比较,差异均无统计学意义(P>0.05);同组内血糖水平、蛋白含量使用后均较使用前有所升高,谷草转氨酶(AST)较使用前均有所降低(P<0.05)。结论含有或不含抑菌剂的混合水溶性维生素配制肠外营养液稳定性相当,均能有效改善新生儿的营养状况。

Objective To analyze the effect and clinical efficacy of two mixed water-soluble vitamins on the stability of parenteral nutrition in neonates.Methods A total of 96 neonates who received parenteral nutrition treatment from July 2018 to July 2019 in Huizhou first people′s hospital were selected as the research subjects.According to the different use of nutrition solutions, they were divided into group A(n=47,mixed water-soluble vitamin with antibacterial agent) and group B(n=49,mixed water-soluble vitamin without antibacterial agent).And the nutrient solution was further divided into low-dose and high-dose groups.The stability of the nutrient solution within 48 hours was tested in the laboratory, and the changes of various growth indicators and the incidence of complications of neonates before and after treatment were statistically analyzed.Results There was no significant difference in pH value between the two groups of different doses(P>0.05).There was no significant difference in the pH values between the two groups within 48 hours after preparation(P>0.05),and the pH values were stable at about 5.8.There was no statistically significant difference in the average milk particle size between the two groups at the same dose(P>0.05).The milk particle size of the two groups increased with the passing of time within 48 hours after preparation, and the differences were statistically significant(F=20.315,14.412,10.143 and 11.362,respectively, P<0.05),and none of them exceed 1μm.There was no significant difference in the polymer dispersion index(PDI) among different doses of the same group(P>0.05),and the PDI of group A was higher than that of group B(P<0.05) at the same dose.PDI value of the two groups increased with time within 48 h of preparation, and the differences were statistically significant(F=4.730,4.833,5.541 and 4.550,respectively, P<0.05).The insoluble particles met the requirements within 48 hours after deployment, and the bacterial culture within 48 hours was negative.There were no significant differences in the amount and time of nutrient solution, the growth of newborn, hospitalization time and the incidence of complications between the two groups(P>0.05).There was no significant difference in biochemical indicators between the two groups after nutrient solution application(P>0.05).In the same group, the blood glucose level and protein content were increased after treatment, and aspartate aminotransferase(AST) were decreased compared with before treatment(P<0.05).Conclusion The stability of parenteral nutrition solution prepared with mixed water-soluble vitamins with or without bacteriostatic agents is similar, which can effectively improve the nutritional status of newborns.