摘要
目的探讨早产儿标准化肠外营养液的配置及其使用的安全性。方法选择2015年6月至2018年11月华西第二医院新生儿重症监护病房收治的胎龄28~34周、生后24 h内入院并在生后48 h内开始肠外营养的早产儿进行回顾性队列研究。收集患儿肠外营养液使用过程中电解质、血糖、静脉炎及静脉导管相关性感染等情况,根据使用肠外营养液种类分为标准化肠外营养液组(标准液组)和个体化肠外营养液组(个体液组)。基于R语言使用EmpowerStats统计软件进行数据分析,采用多元回归方程得出OR值及95%CI。结果共纳入早产儿840例,其中标准液组541例,个体液组299例。标准液组高血糖症[6.3%(34/541)比21.7%(65/299),OR=0.491,95%CI 0.268~0.899]、低钾血症[13.5%(73/541)比59.9%(179/299),OR=0.137,95%CI 0.090~0.208]、高钙血症[25.9%(140/541)比62.8%(188/299),OR=0.249,95%CI 0.162~0.383]、低磷血症[0.2%(1/541)比2.7%(8/299),OR=0.076,95%CI 0.008~0.686]发生率均低于个体液组,差异有统计学意义(P<0.05)。两组导管相关性感染发生率差异无统计学意义(P>0.05)。结论标准化肠外营养液在维持早产儿血糖、血钾及钙磷代谢稳定方面更具有安全性。
Objective To study the configuration and safety of standardized parenteral nutrition solution for premature infants.Methods A retrospective cohort study was used to the premature infants who were admitted to the neonatal intensive care unit of the West China Second Hospital within 24 hours after birth,28~34 weeks gestational age,and began parenteral nutrition within 48 hours after birth from June 2015 to November 2018.Electrolytes,blood sugar,phlebitis and venous catheter-related infection during the use of parenteral nutrient fluids were collected,and divided into standardized parenteral nutrient solution group and individualized parenteral nutrient solution group according to the types of parenteral nutrient fluids used.Data analysis is realized by using EmpowerStats statistical software based on R language.Results A total of 840 premature infants were collected,among them,541 cases of standardized parenteral nutrition solution group and 299 cases of individual parenteral nutrition solution group.Compared with the individual parenteral nutrition solution group,the incidence of hyperglycemia was 6.3%(34/541)vs.21.7%(65/299),OR=0.491,95%CI 0.268~0.899.The incidence of hypokalemia was 13.5%(73/541)vs.59.9%(179/299),OR=0.137,95%CI 0.090~0.208.The incidence of hypercalcemia was 25.9%(140/541)vs.62.8%(188/299),OR=0.249,95%CI 0.162~0.383.The incidence of hypophosphatemia was 0.2%(1/541)vs.2.7%(8/299),OR=0.076,95%CI 0.008~0.686.All the differences were statistically significant(P<0.05).There was no significant difference in the incidence of catheter-related infections between the two groups(P>0.05).Conclusions Standardized parenteral nutrition is safer in maintaining blood glucose,blood potassium and calcium and phosphorus metabolism in premature infants.
作者
郑娟
王华
Zheng Juan;Wang Hua(Department of Neonatology,West China Second University Hospital,Sichuan Universitiy,Chengdu 610041,China;Department of Pediatrics of Zigong Fourth People's Hospital,Zigong 643000,China)
关键词
肠外营养
婴儿
早产
标准化配置
安全性
Parenteral nutrition
Infant,premature
Configuration,standardization
Safety
