不同剂量维生素D对预防早产儿佝偻病的影响及护理对策

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目的探讨不同剂量维生素D3预防早产儿维生素D缺乏性佝偻病的应用效果及护理对策。方法对2014年1月-2016年1月于深圳坪山新区人民医院接受治疗的早产儿85例为研究对象,按照维生素D3使用剂量的不同分为低剂量组(400 IU/天)和高剂量组(800 IU/天)。对比分析两组早产儿治疗后维生素D缺乏性佝偻病的发生率,治疗前后相关生化指标和有效追赶成长率的变化及治疗不良反应发生情况。结果高剂量组早产儿佝偻病发生率为5.55%,低剂量组为18.18%,两组相比差异有统计学意义(P<0.05);高剂量组治疗后血钙含量(3.86±1.04 mmol/L),有效追赶成长率(94.44%)、25(OH)D含量(63.5±4.24ng/L),骨钙素(19.32±1.23μg/l)及骨源性碱性磷酸酶含量(291.4±56.3U/L)均明显高于低剂量组治疗后相应指标,差异有统计学意义(P<0.05);而两组早产儿治疗并发症发生率差异无统计学意义(P>0.05)。结论高剂量维生素D制剂配合相应护理对策,更有利于减少早产儿维生素D缺乏性佝偻病的发生,且不增加并发症发生率,在临床上值得推广应用。 Objective To investigate the effect of different doses of vitamin D3 in prevention of vitamin D deficiency rickets in premature infants and nursing strategies. Methods A total of 85 preterm infants treated at Pingshan New District People’s Hospital of Shenzhen from January 2014 to January 2016 were divided into low dose group (400 IU / day) and high dose group according to the dose of vitamin D3 (800 IU / day). The incidences of vitamin D-deficiency rickets in preterm infants after treatment were compared between the two groups. The changes of relevant biochemical indexes and effective catch-up growth rate before and after treatment and the occurrence of adverse reactions were analyzed. Results The incidence of rickets in preterm infants of high dose group was 5.55%, while that of low dose group was 18.18% (P <0.05). The high dose group had a significant increase of 3.86 ± 1.04 mmol / L ), Effective catch-up growth rate (94.44%), 25 (OH) D content (63.5 ± 4.24ng / L), osteocalcin (19.32 ± 1.23μg / l) and bone alkaline phosphatase (291.4 ± 56.3 U / L) were significantly higher than those in the low-dose group after treatment, the difference was statistically significant (P <0.05). There was no significant difference in the incidence of complications between the two groups (P> 0.05). Conclusion High-dose vitamin D preparations with the appropriate nursing strategies, is more conducive to reduce the incidence of vitamin D deficiency rickets in premature infants, and does not increase the incidence of complications, it is worth promoting the clinical application.
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