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【目的】探讨早期一定量静脉营养和既往较晚少量肠外营养对早产儿生长发育的影响。【方法】将168例早产儿按入院时间随机分为治疗组86例,对照组82例。治疗组给予早期定量肠外营养支持,第1天给予氨基酸1g/(kg.d),以后按1g/(kg.d)的速度增加,增加至3.5g/(kg.d);脂肪乳第1天用量1g/(kg.d),以后按1g/(kg.d)的速度增加,增加至3.5g/(kg.d)。对照组按传统肠外营养较晚给予少量营养支持,出生后第3天开始给予氨基酸和脂肪乳各0.5g/(kg.d),以后按0.5g/(kg.d)的速度增加,增加至3.5g/(kg.d)为止。观察早产儿体重变化、住院天数和宫外生长发育迟缓的临床资料以及血糖、电解质、血脂、胆红素、胆汁酸和肝肾功等生化检测结果。【结果】与对照组相比,治疗组生理性体重下降时间和恢复时间明显缩短,体重日增长量明显增多,住院天数减少,宫外生长发育的发生率明显降低;治疗组电解质紊乱和低血糖的发生率低于对照组,高血糖和低血钙的发生率明显高于对照组(P<0.01);治疗组血清前蛋白、白蛋白、球蛋白、血尿素氮和血脂水平明显高于对照组,两组间总胆红素、胆汁酸和肝功能差异无明显统计学意义(P>0.05)。【结论】早期定量肠外营养能有效促进早产儿生长发育,临床应用较为安全,但尚未达到理想的营养状态,还需进一步研究完善。
【Objective】 To investigate the effect of a certain amount of early parenteral nutrition and a small amount of parenteral nutrition in the past on the growth and development of premature infants. 【Methods】 168 preterm infants were randomly divided into treatment group (n = 86) and control group (n = 82) according to the time of admission. The patients in the treatment group were given early parenteral nutrition support. The patients were given amino acid 1g / (kg.d) on the first day and then increased to 3.5g / (kg.d) at the rate of 1g / (kg.d) 1days 1g / (kg.d), then by 1g / (kg.d) speed increase, increased to 3.5g / (kg.d). The control group received a small amount of nutritional support later than the traditional parenteral nutrition, and 0.5g / (kg · d) of amino acid and fat emulsion were given on the third day after birth, and then increased by 0.5g / (kg · d) To 3.5g / (kg.d) so far. Observe the changes of body weight in preterm infants, hospital days and ectopic growth and development of clinical data and blood glucose, electrolytes, lipids, bilirubin, bile acid and liver and kidney biochemical test results. 【Results】 Compared with the control group, the decrease and recovery time of physiological weight in the treatment group were significantly shortened, the daily body weight gain increased significantly, the days of hospitalization decreased and the incidence of extrauterine growth and development significantly decreased. The electrolyte imbalance and hypoglycemia The incidence of hyperglycemia and hypocalcemia in the treatment group was significantly higher than that in the control group (P <0.01). The levels of serum prealbumin, albumin, globulin, blood urea nitrogen and blood lipids in the treatment group were significantly higher than those in the control group There was no significant difference in total bilirubin, bile acid and liver function between the two groups (P> 0.05). 【Conclusion】 Early quantitative parenteral nutrition can effectively promote the growth and development of premature children. The clinical application is safer, but it has not yet reached the ideal nutritional status, so further study is needed.