摘要
目的研究早产儿胃肠外营养相关性胆汁淤积综合征(PNAC)的危险因素。方法回顾性分析2000年1月至2011年10月静脉营养应用超过14 d的244例早产儿的临床资料,通过病例对照研究调查PNAC发生的危险因素。结果单因素分析发现,PNAC组(n=23)与非PNAC组(n=221)相比,胃肠外营养(PN)总应用时间更长、氨基酸累计用量及脂肪乳累计用量更大、氨基酸每日最高用量及脂肪乳每日最高用量更高、PN应用第14天时的静脉热卡更多、出生体重更小、贫血及新生儿感染发生率更多(P<0.05)。氨基酸累计用量超过PNAC组氨基酸累计用量的非PNAC组早产儿,脂肪乳累计用量大,PN总应用时间长,机械通气使用情况高,胎龄更小。脂肪乳累计用量超过PNAC组脂肪乳累计用量的非PNAC组早产儿,胎龄更小。PN总应用时间超过PNAC组PN总应用时间的非PNAC组早产儿,胎龄更小。结论 PN总应用时间、氨基酸累计用量、氨基酸每日最高用量、脂肪乳累计用量、脂肪乳每日最高用量、PN应用14天时的静脉热卡、低体重、新生儿感染及贫血为PNAC的危险因素,其他危险因素需进一步探究。
Objective To investigate risk factors for parenteral nutrition-associated cholestasis （PNAC） in preterm infants. Methods A retrospective case-control study was performed on 244 preterm infants who received parenteral nutrition （PN） for over 14 days from January 2000 to October 2011. Results Compared with those without PNAC （n = 221 ）, preterm infants with PNAC （n = 23 ） had a longer total duration of PN, a higher total amino acid intake, a higher total lipid intake, a higher maximum daily amino acid intake, a higher maximum daily lipid intake, a higher intravenous calorie intake on the 14th day of PN, a lower birth weight and higher incidence rates of neonatal infection and anemia. Compared with those with PNAC, preterm infants without PNAC who showed a higher total amino acid intake also had a higher total lipid intake, a longer total duration of PN, a higher rate of mechanical ventilation and a lower gestational age. The preterm infants without PNAC who showed a higher total lipid intake also had a lower gestational age. Preterm infants without PNAC who showed a longer total duration of PN also had a lower gestational age. Conclusions Total duration of PN, total amino acid intake, maximum daily amino acid intake, total lipid intake, maximum daily lipid intake, intravenous calorie intake on the 14th day of PN, low birth weight, and neonatal infection and anemia are the risk factors for PNAC. Other risk factors need further investigation.
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2013年第4期254-258,共5页
Chinese Journal of Contemporary Pediatrics
