目的 探讨新生儿重症监护病房(neonatal intensive care unit,NICU)中极低出生体重儿(extremely low birth weight infants,ELBWI)肠道外营养相关性胆汁淤积(parenteral nutrition-associated cholestasis,PNAC)的危险因素。方法 回顾NICU中229例静脉营养支持两周以上的极低出生体重儿的临床资料,比较PNAC组与非PNAC组在胎龄、出生体重等临床资料的差异。结果 极低出生体重儿PNAC发生率为 11.79%(27/229) ,PNAC组患儿胎龄、出生体重小于非PNAC组,而PN持续时间、PN热卡摄入量、脂肪乳最大剂量及累计用量、感染、贫血发生率大于非PNAC组(P<0.05)。结论 低胎龄、低出生体重、PN持续时间过长、PN提供热卡过高、脂肪乳最大剂量及累计用量、感染、贫血是极低出生体重儿发生PNAC的危险因素。
Abstract
objective To explore the risk factors of parenteral nutrition-associated cholestasis (PNAC) in extremely low birth weight infants(ELBWI). Methods The clinical data of 229 ELBWI receiving parenteral nutrition (PN) for more than two weeks in neonatal intensive care unit (NICU) were retrospectively analyzed.The differences between PNAC group and non-PNAC group about gestational age,birth weight,sex,et al were compared. Results The incidence of PNAC was 11.79%(27/229).Compared with non-PNAC group,the average gestational age and birth weight in PNAC group were lower; Average PN duration,average energy intake,the large fat milk dosage and accumulative dosage were higher;The incidence of infection and anemia in PNAC group were higher too(P<0.05). Conclusion The incidence of PNAC is associated with lower gestational age,lower birth weight,longer PN duration,higher energy intake,larger fat milk dosage and accumulative dosage,infection and anemia.
关键词
极低体重儿 /
胃肠外营养 /
胆汁淤积
中图分类号:R722 文献标识码:A 文章编号:1008-6579(2015)08-0870-03 doi:10.11852/zgetbjzz2015-23-08-28
Key words
extremely low birth weight infants /
parenteral nutrition /
cholestasis
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参考文献
[1] Albers MJ,de Gast-Bakker DA,van Dam NA,et al.Male sex predisposes the newborn surgical patient to parenteral nutrition-associated cholestasis and to sepsis[J].Arch Surg,2002,137(7):789-793.
[2] Arnold CJ,Miller GG,Zello GA.Parenteral nutrition-associated cholestasis in neonates :the role of aluminum[J].Nutr Rev,2003,61(9):306-310.
[3] Robinson DT,Ehrenkranz RA.Parenteral nutrition-associated cholestasis in small for gestational age infants[J].J Pediatr,2008,152(1):59-62.
[4] Costa S,Maggio L,Sindico P,et al.Preterm small for gestational age infants are not at higher risk for parenteral nutrition-associated cholestasis[J].J Pediatr,2010,156 (4):575-579.
[5] Koseesirikul P,chotinaruemol S,Ukarapol N.Incidence and risk fators of parenteral nutrition-associated liver disease in newborn infants[J].Pediatr Int,2012,54(3):434-436.
[6] Klein CJ,Revenis M,Kuscnda C,et al.Parenteral nutrition-associatcd conjugated hyperbilirubinemia in hospitalized infants[J].J Am Diet Assoc,2010,110(11):1684-1695.
[7] 史鸽.早产儿胃肠外营养相关性胆汁淤积的高危因素探讨[J].中国基层医药,2009,16(2):289-290.
[8] Goplerud JM.Hyperalimentation associated hepatotoxicity in the newborn[J].Ann Clin Lab Sci,1992,22(2):79-84.
[9] 麦海珊,周伟.胃肠外营养早产儿血清总胆汁酸变化的意义[J].实用儿科临床杂志,2011,26(14):1108-1109.
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