| 极低出生体质量儿肠外营养相关性胆汁淤积危险因素的临床分析 |
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| 引用本文： | 陈桃英,贲晓明.极低出生体质量儿肠外营养相关性胆汁淤积危险因素的临床分析[J].实用儿科临床杂志,2011,26(2):111-113. |
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| 作者姓名： | 陈桃英 贲晓明 |
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| 作者单位： | 1. 南京医科大学附属无锡市人民医院,新生儿科,江苏,无锡,214000
2. 南京医科大学附属南京儿童医院,新生儿科,南京,210008 |
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| 摘 要： | 目的 回顾分析极低出生体质量儿(VLBWI)肠外营养相关性胆汁淤积(PNAC)的发病率和危险因素.方法 对2006年1月-2008年12月在南京儿童医院NICU接受肠外营养(PN)支持超过14 d的64例VLBWI的临床资料进行回顾分析,了解PNAC的发病率;并按PNAC的有无进行分组,对2组的临床资料进行分析比较,并应用Logistic回归模型分析PNAC的危险因素.结果 64例VLBWI中10例发生PNAC,发生率15.63%.PNAC组胎龄为(31.54±2.67 )周,体质量增长(12.14±8.44) g·d-1,均小于无PNAC组患儿(33.30±2.01)周,(17.66±4.36) g·d-1](Pa=0.003).PNAC组患儿住院天数(50.30±32.15) d、PN持续时间(35.00±12.12) d、全静脉营养时间(9.44±8.52) d、氨基酸累计用量(57.62±25.25) g·kg-1、脂肪乳累计用量(55.23±30.60) g·kg-1,均高于无PNAC组.PNAC组先天性心脏病的发病率为30.00%,高于非PNAC组的5.56%,差异有统计学意义(P=0.044).2组患儿的性别、日龄、出生体质量、PN开始日龄、氨基酸和脂肪乳日用量及感染、窒息、颅内出血、机械通气、坏死性小肠结肠炎的发生率比较差异均无统计学意义.Logistic回归分析示:PN持续时间(OR=0.87,95%CI 0.79~0.96,P=0.005)和合并先天性心脏病(OR=39.44,95%CI 2.18~714.24,P=0.013)是PNAC的危险因素.结论 胎龄越小,全静脉营养时间越长、PN持续时间越长,越易发生PNAC.合并先天性心脏病的患儿使用静脉营养时更易发生PNAC.尽早肠内喂养,缩短PN时间,是降低PNAC的重要措施.
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| 关 键 词： | 极低出生体质量儿 肠外营养 胆汁淤积 危险因素 先天性心脏病 |
Clinical Analysis of Risk Factors of Parenteral Nutrition-Associated Cholestasis in Very Low Birth Weight Infants |
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| CHEN Tao-ying
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BEN Xiao-ming.Clinical Analysis of Risk Factors of Parenteral Nutrition-Associated Cholestasis in Very Low Birth Weight Infants[J].Journal of Applied Clinical Pediatrics,2011,26(2):111-113. |
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| Authors: | CHEN Tao-ying BEN Xiao-ming |
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| Institution: | CHEN Tao-ying1,BEN Xiao-ming2(1.Department of Neonatology,Wuxi People's Hosptial Affiliated to Nanjing Medical University,Wuxi 214000,Jiangsu Province,China,2.Department of Neonatology,Nanjing Children's Hospital Affiliated to Nanjing Medical University,Nanjing 210008,China) |
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| Abstract: | Objective To investigate the incidence and analyze the risk factors of parenteral nutrition-associated cholestasis(PNAC)in very low birth weight infants(VLBWI).Methods Retrospective analysis on the data collected from Jan.2006 to Dec.2008 was performed.VLBWI received parenteral nutrition(PN)for more than 14 days in Nanjing Children's Hospital were investigated in this study.Sixty-four neonates were divided into PNAC group and non-PNAC group.The associated factors were analyzed.Results The incidence of PNAC ... |
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| Keywords: | very low birth weight infant parenteral nutrition cholestasis risk factors congenital heart disease |
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