早期静脉营养在早产低出生体重儿中应用.doc

早期静脉营养在早产低出生体重儿中应用[摘要]目的：对比研究两种静脉营养方法对早产低出生体重儿的疗效。方法：按静脉营养方式不同，将不能耐受全胃肠道喂养的早产低出生体重儿随机分为两组，每组各30例，实验组采用早期静脉营养(early parenteral nutrition,EPN)，对照组采用传统静脉营养(traditional parenteral nutrition,TPN)，比较两组患儿2周内体重增长情况，过渡到全胃肠道喂养的时间，静脉营养相关并发症。结果：实验组2周内体重增长均高于对照组（P0.05）；两组静脉营养相关并发症发生率差异无统计学意义（P0.05）。结论：早产儿低出生体重儿采用早期静脉营养比传统静脉营养体重增长快，可以避免早期营养不良的发生，对过渡到全胃肠道喂养的时间没有影响，不会增加静脉营养相关并发症。 [关键词] 静脉营养；早产儿；低出生体重儿 [中图分类号] R473.72 [文献标识码]C [文章编号]1673-7210（2008）08（c）-232-02 The application of early vein nourishment in the premature infants LI Mao-xia, LI Mei,HUANG Zhao-min, ZOU Yong-rong ,YANG Ze-kai (1. The People’s Hospital of Yaan, Yaan 625000,China; 2.The Affiliated Hospital of Yaan Vocational Technical College, Yaan625000,China) [Abstract] Objective:This study aimed to compare the effects of the two methods on nutrition states and the incidence of complication associated with parenteral nutrition（PN）. To investigate the effect of early parenteral nutrition （EPN） on the weight increase of premature infants. Methods:Total 60 survival premature infants with low birth weight or very low birth weight in our hospital were divided into two groups randomly, with 30 infants in each group. The infants in the trial group were given early PN（EPN） to improve weight growing, and those in the control group given traditional PN（TPN）. The body weight, the time taken to attain of full enteral nutrition, and the incidence of complication were recorded daily. All the data were analyzed statistically. Results:Daily weight gain in the first two weeks in the early PN group were much greater than those of the conventional PN group （P0.05）。见表1。 1.2实验方法 1.2.1药品的选择氨基酸选用广东彼迪制药有限公司6%复方氨基酸，脂肪乳剂选用华瑞制药有限公司20%的中长链脂肪乳剂（英脱利匹特）。 1.2.2 营养液的配制采用全合一营养液，即将脂肪乳液、氨基酸、葡萄糖、电解质、维生素、微量元素混合在一起。配制的顺序：先将电解质、水溶性维生素、微量元素加入葡萄糖溶液后放入营养袋，然后将脂溶性维生素加入脂肪乳剂后加入营养袋。配制的营养液由输液泵24 h均匀滴入。 1.2.3 营养液的使用两组患儿均于入院后即建立静脉通道，实验组于生后24 h内即给予氨基酸和脂肪乳；对照组生后第1天只给予葡萄糖，48 h加用氨基酸，72 h加用脂肪乳剂，氨基酸和脂肪乳剂的用量均从0.5 g/kg 开始，以后每天增加0.5 g/kg，最大量为每日2.5～3.0