文章摘要
孙晓丽,周晓玉.极低出生体重儿的早期全静脉营养的临床探讨[J].南京医科大学学报,2008,28(7):921~924
极低出生体重儿的早期全静脉营养的临床探讨
Early total parenteral nutrition in low-birth-weight infants
投稿时间:2008-01-20  
DOI:10.7655
中文关键词: 极低出生体重儿  早期静脉营养  晚期静脉营养  氮平衡  能量摄入
英文关键词: VLBW infant  ETPN  LTPN  nitrogen balance  caloric intake
基金项目:
作者单位
孙晓丽 南京医科大学附属南京儿童医院新生儿科,江苏 南京 210008 
周晓玉  
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中文摘要:
      目的:观察早期大量快速静脉营养和晚期小量静脉营养对极低出生体重儿(VLBW)能量代谢的影响?方法:将63例VLBW患儿随机分成两组,早期全静脉营养组(ETPN)于生后24 h内给予2.0 g/(kg·天)的氨基酸和1.5 g(kg·天)的20%脂肪乳,之后每天增加1.0 g/kg;晚期全静脉营养组(LTPN)于生后24~48 h开始给予氨基酸0.5 g/(kg·天),48~72 h开始给予20%脂肪乳0.5 g/(kg·天),按0.5 g/(kg·天)递增?两组目标剂量均为氨基酸3.5 g/(kg·天),20%脂肪乳3.0 g/(kg·天)?观察比较两组患儿氮平衡,能量摄入,同时比较胆固醇?甘油三酯?胆红素?肌酐?血糖等生化指标?结果:ETPN组在氮储存上明显高过LTPN组(P < 0.01),生后1~5天的能量摄入亦明显升高(P < 0.01)?两组在胆固醇?甘油三酯?胆红素?肌酐上无明显区别?LTPN组的血糖水平较ETPN组明显升高(P > 0.05)?结论:早期全静脉营养可以避免负氮平衡,增加热卡供给,且对早期预后没有明显不良反应?
英文摘要:
      Objective:To observe the effect of early nutrition in very low birth weight infants. Methods:Sixty-three preterm infants with birth weights <1 500 g received parenteral nutrition containing both 2.0 g/(kg·d) amino acids(AA) and 1.5 g/(kg·d) lipid within the first 24 hours with a increase of 1.0 g/(kg·d) in both of them(ETPN group), or solely glucose during the first day with 0.5 g/(kg·d) AA in second day and 0.5 g/(kg·d) lipid in the third day with a increase of 0.5 g/(kg·d) in both of them(ETPN group). The final dose of AA is 3.5 g/(kg·d) and lipid is 3.0 g/(kg·d). To compare nitrogen balances and caloric intake in the two groups,the plasma concentration of cholesterol,triglyceride,bilirubin,creatinine were determined to evaluate the side effect of ETPN. Results:VLBW infants supplemented with ETPN had no major adverse side effects. They got a positive nitrogen balance at the first day and more calories intake. Conclusion:Early total parenteral nutrition administration to VLBW infants results in a positive nitrogen balance and more calories intake.
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