早产儿静脉营养的临床观察

目的:探讨静脉营养早产儿的应用价值及安全性。方法:将64例早产儿随机分为观察组(32例)和对照组(32例),观察组生后第3 d开始应用氨基酸,开始剂量0.5 g/(kg.d),每日增加0.5~3.0 g/kg;生后第4 d开始应用脂肪乳,开始剂量每日0.5 g/kg,每日增加0.5~3.0 g/kg;生后第3 d开始补充维生素及微量元素适量。静脉营养液采用"全合一"方式,包括葡萄糖、氨基酸、脂肪乳、维生素、微量元素,经外周静脉用微量输液泵在24 h内均匀输入,对照组给予一般综合治疗。结果:①两组间胆固醇、甘油三脂、胆红素、尿素氮、碱剩余均无统计学差异。治疗组未发生高胆红素血症及肝肾功能损害。②体重增长比较:观察组生后5~7 d开始增长,住院期间体重平均每日增加(15.24±6.32)g。对照组存活32例,生后7~10 d体重开始增长,住院期间体重平均每日增加(9.87±3.03)g,两组比较有差异(P<0.05)。③治愈率比较:观察组32例治愈31例,自动出院1例,治愈率96.87%;对照组32例患儿,治愈24例,好转4例,死亡2例,自动出院2例,治愈率75%。两组比较差异有显著性(P<0.05)。④并发症比较:观察组32例中发生并发症6例,发生率18.75%,对照组32例中发生并发症14例,发生率43.75%,两组比较差异有显著性(P<0.05)。结论:周围静脉营养能使早产儿更快更早地增加体重,减少并发症,降低病死率,提高早产儿的存活率和生存质量。

Clinical observation on parenteral nutrition regimen in preterm infants

Objective:To evaluate the application value and safety of peripheral intravenous alimentation in premature infants under medical treatment.Methods: 64 premature infants were randomly assigned into observation group(32) or control group(32).Amino acid solution was given on the third day of life beginning with a dosage of 0.5 g/kg per day followed by an increase of it in a dose of 0.5 g/kg.a day up to a maximum of daily 3.0 g/kg.Lipids were started on the forth day of the new life with a dosage of 0.5 g/kg per day followed by a daily increase of 0.5 g/kg up to a maximum of 3.0 g/kg a day.Nutritional solution was given with all-in-one,which included glucose,amino acids,lipids,vitamins and trace elements.Parenteral nutrition was administrated through peripheral vein with micro-computer infusion pump in 24 hours a day.The control group received general treatment.Results: ①There was no difference in concentration of cholesterol,triglyceride,bilirubin,blood urea nitrogen and base excess between the two groups,and no hyperbilirubinemia,liver or kidney damages occurred in observation group.②The weight gain of the infants in the observation group began after birth of from the 5th to 7th day with a daily average of(15.24±6.32)g.As far as the control group was concerned,body weight of the infants tended to increase after 7～10 days of their birth with daily average of(19.87±3.03)g,which suggested significant difference(P<0.05).The percentage of complication was 18.75 % compared with 43.75% in the control group and that was significantly different(P<0.05).Conclusion:Preterm infants can receive parenteral nutrition regimen with little side effects.As compared with control group,parenteral nutrition may improve the weight gain,shorten hospital stay and cut down complications of preterm infants.