低甲状腺素血症早产儿喂养不耐受的早期干预治疗

目的探讨甲状腺素片早期干预治疗早产儿暂时性低甲状腺素血症合并喂养不耐受的临床意义。方法将66例低甲状腺素血症合并喂养不耐受的早产儿随机分为治疗组和对照组,对照组予常规治疗;治疗组在常规治疗的基础上给予鼻饲或口服左旋甲状腺素每日5mg.kg-1,1天1次,连续7d;均采静脉血作甲状腺5项动态测定,比较两组早产儿喂养不耐受改善情况及甲状腺功能恢复情况。结果治疗组在奶量增加、残余奶量、恢复出生体重时间、达全肠内喂养时间、留置胃管时间、住院时间较对照组差异有统计学意义（P〈0.01或P〈0.05）。治疗后14d复查甲状腺素水平治疗组已基本正常,对照组5项水平仍较低;除TSH外,两组差异有统计学意义（P〈0.01或P〈0.05）。结论早期小剂量短疗程甲状腺素片治疗低甲状腺素血症早产儿喂养不耐受疗效显著,同时使甲状腺功能恢复正常,改善低甲状腺素血症早产儿的预后。

The clinical significance of thyroxine by early interventing with transient low thyroxine hyperlipidemia combined feeding intolerance in preterm children

OBJECTIVE To investigate the clinical significance of thyroxine by early interventing with transient low thyroxine hyperlipidemia combined feeding intolerance in preterm children.METHODS 66 patients with transient low thyroxine hyperlipidemia combined feeding intolerance are randomly divided into treatment group and control group,control group treated with conventional therapy;treatment group are given treatment on the basis of nasal or oral L-thyroxine(5mg/(kg·d)),once a day,continuous 7d;All patients are taking venous blood for five dynamic measurement of thyroid.Comparing the two groups with the situation of feeding intolerance and the recovery of thyroid function.RESULTS The treatment group has statistically significant in milk increasing,residual milk,time to regain birth weight,time to full enteral feeding,time to indwelling gastric tube and hospital stay than the control group(P<0.01 or P<0.05).The thyroid hormone level of treatment group after treatment 14d,and 5 level of control group is still low;Except TSH,there is statistically significant between the two groups(P<0.01 or P<0.05).CONCLUSION Thyroxine with early low-dose short course in treatment of preterm children with transient low thyroxine hyperlipidemia combined feeding intolerance has significant effect.At the same time making thyroid function returned to normal,improving the prognosis in preterm children with low thyroxine hyperlipidemia.