早产儿肠外营养的疗效研究

目的:探讨早产儿早期应用传统方法及应用肠外营养方法的疗效。方法:将喂养困难摄入量少的早产儿120例(胎龄28～35周,体重1 200～2 500 g),随机分为两组,早期组于生后24 h内添加氨基酸及脂肪乳;晚期组采用传统的肠外营养方法,即72 h以后应用氨基酸及脂肪乳并结合鼻饲喂养,两组均尽早经口微量喂养。两组患儿均于生后第1天与第7天检测肝功能、血气分析,血常规,尿素氮,每天监测体重、微量血糖。比较两组患儿体重下降情况、恢复至出生体重时间、第3天时的热量、第7天时的热量、肠外营养的天数、住院总天数、过渡到全肠道营养所需的天数、并发症发生情况及血清胆固醇、三酰甘油、胆红素、尿素氮、血小板的变化。结果:早期组患儿恢复至出生体重时间较传统组短(P<0.01),第3天时的热量,第7天时的热量较传统组高(P<0.01),体重下降情况、并发症发生情况两组差异无统计学意义(P>0.05);两组患儿生后相同日龄测得的直接胆红素、总胆固醇、三酰甘油及尿素氮差异均无统计学意义(P>0.05)。结论:早期积极规范的肠外营养对早产儿是安全有效的。

Curative study of parenteral nutrition in premature infants

Objective To investigate the effects of two parenteral nutrition method.Method 120 premature infants(gestational age between 28 and 35weeks,birthweight between 1 200 and 2 500 g) who could not tolerate full enteral feeding were randomly divided into two groups.Early nutrition group was fed by amino acids and fat emulsion within 24 hours after birth.Later nutrition group was treated with the traditional method of parenteral nutrition,received amino acids and fat emulsion after 72 hours after birth.According to the conditions,two groups received minimal-feeding orally.Body weight was monitored everyday,blood urea nitrogen,liver function,capillary blood glucose were checked at first and the seventh day after birth.Results In comparison with the later nutrition group,treturning time to birth weight was shorter,the calorie at the third and the seventh days were higher than those in the early nutrition group(P<0.01),while there were no significant differences in the weight loss rate,incidence of complication between two groups(P>0.05).Differences in directbilirubin,total cholesterol,triglyceride,and blood urea nitrogen were not significant between two groups(P>0.05).Conclusion Early aggressive and strict parenteral nutritional support is useful and safe for premature infants.