目的 分析早产儿胆汁淤积的临床及随访情况,为合理诊治及随访提供依据。方法 对2010年1月-2014年6月湖南省儿童医院收住入院的1 894例早产儿进行筛查,73例达到胆汁淤诊断标准,对这73例进行回顾性分析。并按有无肠外营养相关胆汁淤积(PNAC)分组,对两组资料进行比较,并对危险因素进行分析。结果 早产儿淤胆病因中PNAC56例(76.71%),全身感染11例(15.07%),胆道闭锁1例(1.37%),其它原因5例(6.85%)。PNAC组和无PNAC组临床资料比较:住院天数、PN持续时间、全静脉营养时间、氨基酸总量、脂肪乳总量之间的差异均有统计学意义(P<0.05)。PN持续时间、氨基酸总量、脂肪乳总量是PNAC的危险因素。早产儿胆汁淤积的治愈和好转率是94.52%(69/73)。放弃治疗4例,出院后4例均死亡。结论 早产儿胆汁淤积病因繁多,相对而言,除PNAC外,胆汁淤积的病因更为复杂。早产儿胆汁淤积经治疗,疗效显著。

Objective To analyze clinical features and follow-up of cholestasis in preterm infants for better diagnosis,treatment and follow-up plans. Methods In 1 894 cases,there were 73 cases diagnosed with cholestasis.A retrospective study was conducted for 73 cases of cholestasis from January 2010 to June 2014 of Hunan Children's Hospital.Neonates were divided into parenteral nutrition associated cholestasis (PNAC) group and non-PNAC group.The associated factors were analyzed. Results In the 78 cases,58 cases of male,female was 15 cases.The efiologies of 56 term infants were parenteral nutrition,associated with cholestasis(PNAC)(n=56,76.71%),11 term infants were systemic infection (n=11,15.07%),biliary tract disorders (n=1,1.37%), others (n=5,6.85%).The comparison of clinical datas of PNAC group and non PNAC:differences of the hospitalization days,PN time duration,total parenteral nutrition,total quantity of amino acids,fat milk total were statistically significant (P<0.05).The dangerous factors of PNAC were PN total duration,total amino acids,and fat milk.The rate of recovery was 94.52%(69/73).Four cases of giving-up treatment died after discharge. Conclusions The etiologies of neonatal cholestasis are diverse.It may be more complicated than PNAC.The effect after treatment is remarkable.