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目的比较不同热氮配方肠外营养(PN)在早产儿中的应用效果。方法对2008年1月至2010年12月入住本院新生儿病区(胎龄为27～36周、体重为0.9～1.60kg)、应用肠外营养(parenteral nutrition,PN)2周以上的低体重早产儿74例进行回顾分析,按照实施PN热氮的高低分为高热氮组(36例)、低热氮组(38例),两组均于生后12～24h应用PN,分别比较两组患儿体重下降幅度、恢复至出生体重时间、恢复出生体重后日平均增长值、PN使用时间、过渡到全肠内营养(enteral nutrition,EN)的时间、住院天数以及静脉炎、肝损害、高血糖、高脂血症、呼吸暂停的发生率。结果低热氮组PN使用时间、过渡到全EN的时间及静脉炎、肝损害、高血糖、高脂血症、呼吸暂停的发生率均小于高热氮组,差异有统计学意义(P<0.05);而患儿体重下降幅度、恢复至出生体重时间大于高热氮组,差异有统计学意义(P<0.05);恢复出生体重后的日平均增长值、住院天数两组差异无统计学意义(P>0.05)。结论低热氮PN有利于患儿早期过渡到全EN、PN的使用时间短,静脉炎、肝损害、高血糖、高脂血症及呼吸暂停的发生率低;而高热氮PN患儿体重下降幅度小,恢复至出生体重的时间少。本研究提示临床应综合考虑患儿个体情况,选择适合的PN支持方式。
Objective To compare the effects of different PN formulas on preterm infants. Methods From January 2008 to December 2010, neonates were admitted to our hospital for neonatal ward (gestational age ranged from 27 to 36 weeks, weight ranged from 0.9 to 1.60 kg). Patients with parenteral nutrition (PN) over 2 weeks 74 cases of preterm infants with weight were retrospectively analyzed. According to the level of PN hot nitrogen, 36 cases were divided into high heat-nitrogen group and low-heat nitrogen group (38 cases). Both groups were treated with PN at 12-24 hours after birth. Weight loss in children, return to birth weight, average daily growth after birth weight recovery, time to PN use, time to enteral nutrition (EN), length of hospital stay, phlebitis, liver damage, high Blood glucose, hyperlipidemia, apnea incidence. Results The duration of PN administration, the time of transition to EN, and the incidence of phlebitis, liver damage, hyperglycemia, hyperlipidemia and apnea were all less in the hypothermal group than in the hyperpyrone group (P <0.05) (P <0.05). However, there was no significant difference between the two groups (P> 0.05). However, there was no significant difference between the two groups (P> 0.05) > 0.05). Conclusions Low thermal nitrogen PN is beneficial to the early transition of children to EN. The use of PN is short, and the incidence of phlebitis, liver damage, hyperglycemia, hyperlipidemia and apnea is low. However, Small, less time to recover to birth weight. This study suggests that clinical should be considered in children with individual circumstances, select the appropriate PN support.