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目的探讨早产低体质量儿胃肠外营养相关性胆汁淤积(PNAC)的高危因素及防治措施。方法对接受“全合一”方式进行胃肠外营养(PN)≥7 d的134例早产低体质量儿的临床资料进行回顾性分析。按是否发生PNAC分为PNAC组和非PNAC组,并进行临床资料比较。结果 134例低体质量儿中发生PNAC 11例(8.21%)。分析结果显示,胎龄、出生体质量、PN持续时间、PN中脂肪乳剂平均每日用量及PN中热量每日摄入量在两组间的差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示合并败血症、真菌感染是PNAC的高危因素。结论 PNAC发生与低胎龄、低出生体质量、长PN持续时间、PN提供热量过高、脂肪乳剂过量及是否伴有合并症密切相关。
Objective To investigate the risk factors and preventive measures of parenteral nutrition-associated cholestasis (PNAC) in preterm low birth weight infants. Methods Retrospective analysis was performed on the clinical data of 134 preterm low birth weight children who underwent parenteral nutrition (PN) ≥7 days. According to the occurrence of PNAC is divided into PNAC group and non-PNAC group, and clinical data comparison. Results 134 cases of low birth weight PNAC occurred in 11 cases (8.21%). The results showed that the differences of gestational age, birth weight, PN duration, PN fat emulsion daily intake and PN daily calorie intake between the two groups were statistically significant (both P <0.05). Multivariate Logistic regression analysis showed that with sepsis, fungal infection is a risk factor for PNAC. Conclusions The occurrence of PNAC is closely related to low gestational age, low birth weight, long PN duration, high caloric value of PN, excess fat emulsion and complications.