新生儿胃肠外营养相关性胆汁淤积综合征的危险因素分析

目的分析新生儿胃肠外营养相关性胆汁淤积综合征（PNAC）的危险因素，为临床提供理论依据。方法选择2010年5月～2013年4月本院收治的150例接受肠外营养治疗〉15d的新生儿作为研究对象．根据是否发生胆汁淤积综合征分为病例组与对照组，其中病例组78例，对照组72例，总结所有研究对象的临床基本资料，比较胃肠外营养持续时间、禁食时间、体重增长、新生儿胎龄等一般资料，分析危险因素。结果病例组的胃肠外营养持续时间、禁食时间较对照组长，氨基酸及脂肪乳提供热量比率高于对照组，每天总热量低于对照组。多因素分析结果显示，胃肠外营养持续时间、禁食时间、新生儿体重较低、氨基酸脂肪乳热量比率高是发生新生儿PNAC的危险因素。结论新生儿PNAC与新生儿体重、禁食时长、胃肠外营养持续时间、氨基酸及脂肪乳热量比率有关，应从相关危险因素着手降低胆汁淤积综合征的发病率。

Analysis of risk factors for neonatal parenteral nutrition associated cholestasis

Objective To analyze the risk factors for neonatal parenteral nutrition associated cholestasis （PNAC）,in order to provide theoretical basis for clinical practice. Methods 150 newborns who received parenteral nutrition were selected as the subjects in our hospital from May 2010 to April 2013.The newborns were divided into case group （n=78） and control group （n=72） according to the presence of cholestasis,all the research object of basic clinical data was summa- rized,the duration of parenteral nutrition,abrosia time,weight gain,neonatal gestational age such as general data was compared respectively,the risk factors were analyzed. Results The duration of parenteral nutrition and abrosia time in case group was longer than that of the control group respectively,the proportion of calories provided by amino acids and lipid emulsion in case group was higher than that of the control group respectively,the daily total calories in case group was lower than that of the control group.Multiple factor analysis showed that the duration of parenteral nutrition, fasting time, lower neonatal weight and higher proportion of calories provided by amino acids and lipid emulsion were risk fac- tors for neonatal parenteral nutrition associated cholestasis. Conclusion The neonatal parenteral nutrition associated cholestasis is correlated with the neonatal weight,abrosia time,duration of parenteral nutrition and proportion of calories provided by amino acids and lipid emulsion.Therefore,the risk factors can be a good starting point to reduce the inci- dence of cholestasis.