多种油脂肪乳在极低出生体重早产儿中的应用效果

Application Effect of Multi-oil Fat Emulsion in Very Low Birth Weight Premature Infants

目的:分析多种油脂肪乳(MOFE)在极低出生体重(VLBW)早产儿治疗中的应用效果。方法:将赣南医学院第一附属医院2021年1月—2022年11月收治的45例VLBW早产儿作为本次观察对象。根据随机数字表法将患儿分成MOFE组、中/长链脂肪乳(MCFE/LCFE)组、长链脂肪乳(LCFE)组,各15例。分析三组的治疗时间与住院总费用、并发症发生率、生化及炎症指标、体格生长情况。结果:MOFE组胃肠外营养时间和住院时间均短于MCFE/LCFE组、LCFE组,MOFE组住院总费用少于MCFE/LCFE组和LCFE组,差异均有统计学意义(P<0.05)。MOFE组肠外营养相关性胆汁淤积(PNAC)发生率显著低于MCFE/LCFE组和LCFE组,且MOFE组的并发症总发生率低于MCFE/LCFE组和LCFE组,差异均有统计学意义(P<0.05)。三组丙氨酸氨基转移酶(ALT)、直接胆红素(DBIL)、总胆汁酸(TBA)、γ-谷氨酰转肽酶(GGT)、甘油三酯(TG),降钙素原(PCT)、C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)、体重、头围、身长组别与时间的交互效应均有统计学意义(P<0.05),三组组内不同时间点的时间单独效应比较,差异均有统计学意义(P<0.05)。入院后1~4周,MOFE组TG、CRP、SAA均为三组最低;入院后2~4周,MOFE组DBIL、TBA、PCT均为三组最低;入院后3~4周,MOFE组GGT为三组最低;入院后4周,MOFE组体重为三组最高,差异均有统计学意义(P<0.05)。结论:在VLBW早产儿的营养治疗中使用MOFE较MCFE/LCFE、LCFE可缩短住院时间,减少治疗费用,减少PNAC的发生,在调节炎症反应上具有优势,具有良好的安全性。

Objective:To analyze the clinical effect of Multi-oil Fat Emulsion(MOFE)in the treatment of very low birth weight(VLBW)premature infants.Method:A total of 45 VLBW premature infants treated in the First Affiliated Hospital of Gannan Medical University from January 2021 to November 2022 were selected as the observation objects.According to the random number table method,they were divided into the MOFE group,the Medium and Long Chain Fat Emulsion(MCFE/LCFE)group,and the Long Chain Fat Emulsion(LCFE)group,with 15 cases in each group.The treatment time,total hospitalization cost,incidence of complications,biochemical and inflammatory indicators and physical growth of the three groups were analyzed.Result:The duration of parenteral nutrition and length of hospital stay in the MOFE group were shorter than those in the MCFE/LCFE group and LCFE group,the total hospitalization cost of the MOFE group was less than that in the MCFE/LCFE group and LCFE group,the differences were statistically significant(P<0.05).The incidence of PNAC in the MOFE group was significantly lower than that in the MCFE/LCFE group and LCFE group,and the total incidence of complications in the MOFE group was lower than that in the MCFE/LCFE group and LCFE group,with statistical significance(P<0.05).The interaction effect of group and time about ALT,DBIL,TBA,GGT,TG,PCT,CRP,SAA,weight,head circumference and body length in the three groups were statistically significant(P<0.05),and the individual effects of time at different time points in the three groups were statistically significant(P<0.05).1-4 weeks after admission,the TG,CRP and SAA in the MOFE group was the lowest among the three groups;2-4 weeks after admission,the DBIL,TBA,PCT in the MOFE group were the lowest among the three groups;3-4 weeks after admission,the GGT in the MOFE group was the lowest among the three groups;4 weeks after admission,the body weight in the MOFE group was the highest among the three groups,the differences were statistically significant(P<0.05).Conclusion:Compared with MCFE/LCFE and LCFE,the use of MOFE in the nutritional treatment of VLBW premature infants can shorten the length of hospital stay,reduce the cost of treatment and reduce the occurrence of PNAC,and has advantages in regulating inflammatory response and has good safety.