摘要
目的总结分析极低出生体重(VLBW)早产儿发生胃肠外营养相关性胆汁淤积综合征(PNAC)的危险因素,指导PNAC的临床防治。方法回顾性分析我院2012-01～2017-12期间胃肠外营养时间大于2周的VLBW早产儿共80例,按是否发生PNAC分为PNAC组及无PNAC组,对比两组的临床指标,将组间存在显著差异的指标进行单因素及多因素回归分析,了解PNAC的相关危险因素与独立危险因素。结果 80例VLBW早产患儿中,PNAC发生率8. 75%; PNAC组与无PNAC组相比,其胃肠外营养持续时间、达到全胃肠内营养时间、氨基酸累积用量及使用时间、脂肪乳剂使用时间显著延长;PNAC组葡萄糖累积用量、感染率、贫血比率均较无PNAC组显著增高。VLBW早产儿的出生体重、胃肠外营养持续时间、达到全胃肠内营养时间、氨基酸累积用量及使用时间、脂肪乳剂使用时间、感染率为PNAC的相关危险因素;其中,独立危险因素为氨基酸累积用量与感染率。结论 VLBW早产儿患PNAC与多种因素相关,因此PNAC的防控需从多方面着手,如尽量减少氨基酸用量,积极防止感染等。
Objective To analyze risk factors for parenteral nutrition-associated cholestasis( PNAC) in very low birth weight( VLBW) preterm infants. Methods A retrospective investigation of 80 VLBW preterm infants was performed from January 2013 to November 2017 in our Hospital. The infants were divided into two groups: PNAC group and non-PNAC group. Major clinical indexes were compared between two groups. Relative risk factors and independent risk factors for PNAC were analyzed. Results The incidence of PNAC in 80 VLBW preterm infants was 8. 75%. Compared with non-PNAC group,duration of parenteral nutrition, time to reach total enteral nutrition,duration of amino acid and application time of fat and glucose were significantly increased in PNAC group. The accumulated doses of amino acid,and incidences of infection and anemia were higher in infants with PNAC than in infants without PNAC.A variety of factors were related to PNAC,including birth weight,duration of parenteral nutrition,time to reach total enteral nutrition, accumulated doses and duration of amino acid,application time of fat and infection rate. Cumulative amount of amino acids and infection rate were respectively independent risk factors. Conclusion The prevalence of PNAC in very low birth weight preterm infants is related to many factors. Therefore,the prevention and control of PNAC needs to be performed from various aspects,such as minimizing the amount of amino acids and actively preventing infection in those babies.
作者
平莉莉
翟淑芬
张淑彦
PING Lili;ZHAI Shufen;ZHANG Shuyan(Neonatal Unit,Department of Pediatrics,Handan Central Hospital,Handan 056000,China;Department of Pediatrics,Affiliated Hospital of Hebei University of Engineering)
出处
《山西医科大学学报》
CAS
2018年第12期1516-1519,共4页
Journal of Shanxi Medical University
基金
河北省医学科学研究重点课题(20150456)
关键词
胆汁淤积
胃肠外营养
极低出生体重儿
危险因素
cholestasis
parenteral nutrition
very low birth weight preterm infants
risk factors
