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目的探讨极低出生体质量儿进行早期静脉营养治疗的临床效果及安全性。方法对93例不能耐受胃肠道营养的极低出生体质量儿随机分成观察组(47例)和对照组(46例)。观察组在生后24h即开始静脉营养,对照组生后先给予葡萄糖静脉滴注,第3天开始静脉营养。两组患儿每天测体质量、监测血糖,生后第1、7、14天检验血生化。比较两组患儿生理性体质量下降时间、住院天数、常见并发症发生率、死亡率和各项生化指标的差异。结果两组比较观察组生理性体质量下降期时间短、住院天数少、并发症发生率和死亡率低,差异有统计学意义;两组生化指标ALT、TBIL、DBIL、TG、CHOL比较,差异无统计学意义。结论极低出生体质量儿早期静脉营养,可缩短生理性体质量下降期,促进生长发育,减少住院天数,降低并发症发生率及死亡率,没有造成肝脏损害,是安全可行的。
Objective To investigate the clinical efficacy and safety of early intravenous nutrition in very low birth weight children. Methods Ninety-three children with very low birth weight who could not tolerate gastrointestinal nutrition were randomly divided into observation group (n = 47) and control group (n = 46). The observation group started intravenous nutrition at 24h after birth, while the control group received intravenous glucose infusion after birth and began intravenous nutrition on the third day. Two groups of children daily body mass, blood glucose monitoring, 1,7,14 days after birth blood biochemical tests. The differences of physical body weight decline time, days of hospitalization, incidence of common complication, mortality and biochemical indexes were compared between the two groups. Results Compared with the control group, the decline of physical quality of the two groups was short, the days of hospitalization were few, the complication rate and mortality rate were lower, the difference was statistically significant. There were significant differences in biochemical indexes ALT, TBIL, DBIL, TG and CHOL between the two groups No statistical significance. Conclusions Very early low birth weight infant intravenous nutrition can shorten the decline of physiological body mass, promote growth and development, reduce hospital stay, reduce the incidence of complications and mortality, without causing liver damage, is safe and feasible.