论文部分内容阅读
目的:观察19AA-1氨基酸作为全静脉营养的氮源对严重消化道畸形患儿术后营养支持的疗效及安全性,为临床新生儿外科严重消化道畸形手术后完全静脉营养实施配方提供实验依据。方法:选取我院2011年10月至2014年4月新生儿外科重症监护病房收治的严重消化道畸形需手术治疗的患儿,随机分为观察组和对照组各50例,观察组为使用小儿氨基酸(19AA-1)为氮源的全肠外营养(TPN),对照组使用其他氨基酸为氮源的TPN,比较两组患儿术前、术后7 d的营养状况指标、肝肾功能指标以及患儿术后出现的并发症及总住院时间等。结果:两组患儿性别、胎龄、体质量、分娩方式、身长、头围等比较差异均无统计学意义(P>0.05);术前两组患儿的营养指标包括体质量、白蛋白(Alb)、总蛋白(TP)、前白蛋白(PA)比较差异均无统计学意义(P>0.05),而在术后7 d时,观察组患儿的体质量、Alb、TP、PA水平均显著高于对照组患儿(P<0.01);两组患儿术前、术后7 d的肝肾功能指标(ALT、AST、TBIL、BUN、CREA等)比较差异均无统计学意义(P>0.05);两组患儿的术后并发症发生率比较差异无统计学意义,观察组患儿的平均住院时间短于对照组(P<0.01)。结论:严重消化道畸形术后采用19AA-1为氮源的TPN比使用其他氨基酸为氮源的TPN改善患儿营养状况更佳,住院时间更短,对患儿的肝肾功能影响较小,术后并发症较少,安全性高。
Objective: To observe the efficacy and safety of 19AA-1 amino acid as a nutrient source for total parenteral nutrition for postoperative nutritional support in children with severe gastrointestinal malformations and to provide experimental evidence for the formulation of complete parenteral nutrition after clinical operation for severe gastrointestinal malformations in neonates . Methods: A total of 50 children in our hospital who were treated with surgical treatment of severe gastrointestinal malformations admitted to neonatal surgical intensive care unit from October 2011 to April 2014 were randomly divided into observation group (50 cases) and control group The amino acids (19AA-1) were the source of total parenteral nutrition (TPN). The control group used TPN with other amino acids as nitrogen source. The nutritional status indexes, liver and kidney function indexes As well as children with complications and total hospital stay. Results: There were no significant differences in sex, gestational age, body weight, mode of delivery, body length, head circumference between the two groups (P> 0.05). Nutritional parameters of two groups of children before operation included body weight, albumin (Alb), total protein (TP) and prealbumin (PA) were not significantly different between the two groups (P> 0.05) The levels of ALT, AST, TBIL, BUN and CREA in preoperative and postoperative 7th day in both groups were not significantly different (P <0.01) (P> 0.05). There was no significant difference in the incidence of postoperative complications between the two groups. The average length of stay in the observation group was shorter than that in the control group (P <0.01). CONCLUSIONS: TPN with 19AA-1 as a nitrogen source after severe gastrointestinal malformations has better nutritional status, shorter hospital stay and less effect on liver and kidney function than children with other amino acids as a nitrogen source. Less postoperative complications, high safety.