极低出生体重儿肠外营养相关性胆汁淤积危险因素分析及防治措施

目的分析极低出生体重儿(VLBWI)肠外营养相关性胆汁淤积(PNAC)发生的危险因素并提出防治措施。方法对2002年1月—2007年6月我院新生儿科重症监护病房的肠外营养(PN)>14d的36例VLBWI临床资料,按PNAC的有无分组进行单因素及多因素Logistic回归分析。结果PNAC发生率16.67%。对可能的12个危险因素按α=0.05的水准单因素分析获得有意义的相关因子9个进入多因素模型。分析结果显示PN氨基酸用量、PN脂肪乳用量、PN持续时间和开始喂养时间与PNAC等密切相关。向前逐步筛选法显示PN持续时间是PNAC的独立高危因素(OR值4.410,95%CI=0.026～5.031)。结论开始胃肠喂养日龄越长,PN热卡摄入量越大。PN持续时间越长,PN的成分用量越大,发生PNAC的危险性越大。尽早肠内喂养,缩短PN时间,是降低PNAC的重要措施。

The risk factor and prevention measure of PNAC in very low birth weight infants

Objective To determine the risk factor and the prevention measure of parenteral nutrition associated cholestasis(PNAC)in very low birth weight infant(VLBWI).Methods Collected the clinical data 36 of VLBWI,with whan the parenteral nutrition(PN)was carried for more than 14 days in newborn intensive care unit of our hospital,were divided into groups with PNAC or without PNAC.Single factor or multiple factor Logistic regression were used for further analysis.Results The incidence of PNAC was 16.67%,Through sing...