极低出生体重儿肠道外营养相关性胆汁淤积的临床研究

被引：44

作者：

李卉

冯琪

王颖

郭在晨

机构：

[1] 北京大学第一医院儿科

来源：

新生儿科杂志 | 2005年 / 02期

关键词：

极低出生体重儿; 肠道外营养; 胆汁淤积; 发生率; 危险因素;

D O I：

暂无

中图分类号：

R722.6 [早产儿疾病];

学科分类号：

100202 ;

摘要：

目的研究极低出生体重儿(VLBWI)肠道外营养相关性胆汁淤积(PNAC)的发生率、危险因素及预后。方法回顾分析43名接受肠道外营养(PN)超过14d的VLBWIPN相关的临床及实验室指标,并行多因素Logistic回归分析及单因素分析。结果PNAC发生率20.9％。PNAC组和无PNAC组相比,PN持续时间及全肠道外营养时间久、氨基酸及脂肪乳累计用量大、生后14d时静脉非蛋白热卡所占比例高。多因素分析显示,氨基酸累计用量及感染为PNAC发生的危险因素。随PN持续时间的延长,所有患儿结合胆红素(DBIL)、碱性磷酸酶(ALP)、总胆汁酸(TBA)均有明显的升高,出生2周以后的血清DBIL、DBIL/TBIL、ALP及TBA水平在PNAC组与无PNAC组间差异有显著性。9例PNAC患儿中2例死亡,7例好转出院。结论感染及氨基酸累计用量为PNAC发生的危险因素。PN持续时间越久,肠道外营养成分用量越大,PNAC发生的危险性越高。动态监测DBIL、ALP、TBA对早期发现PNAC有帮助。

引用

页码：57 / 61

页数：5

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