CAJ | 학술논문

【目的】探讨极低出生体质量儿（VLBWIs）对早期经外周中心静脉置管下肠外营养的耐受性及其临床效果。【方法】将本院新生儿科住院的不能耐受全胃肠道营养的早产 VLBWIs患儿98例随机分为两组，观察组49例于出生2 h内经外周中心静脉置管应用肠外营养；常规治疗组49例于生后48 h开始应用传统的静脉营养方案。住院期间计算出两组患儿热卡、蛋白质，监测血糖、头围、身长，住院期间定期抽血测定各项生化指标，并进行统计学分析。【结果】出生3d观察组所摄入热卡、蛋白质分别达早产儿摄入标准，与常规治疗组比较，差异有统计学意义（P＜0．01）；出生9 d观察组所摄入热卡、蛋白质与常规治疗组比较，差异无统计学意义（P＞0．05）；出生3 d、9 d、21 d观察组热卡和蛋白质累积丢失，明显低于常规治疗组，差异有统计学意义（P＜0．01）。观察组恢复正常出生体质量时间明显短于常规治疗组，差异有统计学意义（P ＜0．01）；观察组头围、身长增长较常规治疗组快，差异有统计学意义（P＜0．05）；两组间比较均未增加相应的并发症。【结论】VLBWIs早期经外周中心静脉置管下足量肠外营养耐受性好，体质量增长快，达全胃肠喂养时间缩短，没有增加肠外营养相关并发症。
【목적】탐토겁저출생체질량인（VLBWIs）대조기경외주중심정맥치관하장외영양적내수성급기림상효과。【방법】장본원신생인과주원적불능내수전위장도영양적조산 VLBWIs환인98례수궤분위량조，관찰조49례우출생2 h내경외주중심정맥치관응용장외영양；상규치료조49례우생후48 h개시응용전통적정맥영양방안。주원기간계산출량조환인열잡、단백질，감측혈당、두위、신장，주원기간정기추혈측정각항생화지표，병진행통계학분석。【결과】출생3d관찰조소섭입열잡、단백질분별체조산인섭입표준，여상규치료조비교，차이유통계학의의（P＜0．01）；출생9 d관찰조소섭입열잡、단백질여상규치료조비교，차이무통계학의의（P＞0．05）；출생3 d、9 d、21 d관찰조열잡화단백질루적주실，명현저우상규치료조，차이유통계학의의（P＜0．01）。관찰조회복정상출생체질량시간명현단우상규치료조，차이유통계학의의（P ＜0．01）；관찰조두위、신장증장교상규치료조쾌，차이유통계학의의（P＜0．05）；량조간비교균미증가상응적병발증。【결론】VLBWIs조기경외주중심정맥치관하족량장외영양내수성호，체질량증장쾌，체전위장위양시간축단，몰유증가장외영양상관병발증。
[Obj ective]To explore the tolerance and clinical efficacy of early parenteral nutrition through pe-ripheral central venous catheter in very low birth weight infants(VLBWIs).[Methods]Totally 98 VLBWIs who were not tolerant to full enteral nutrition in neonatology department of our hospital were randomly divided into two groups.The observation group(n=49)received parenteral nutrition through peripheral central venous catheter within 2h after birth,while the routine treatment group(n=49)received traditional venous nutrition scheme at 48h after birth.Calories and protein in two groups during hospitalization were calculated.Blood glucose,head circumference and body weight were monitored.Blood samples were collected to determine biochemical indexes. All the results were statistically analyzed.[Results]Calories and protein intake in observation group at 3 days after birth reached the intake standard of premature infant,and there was significant difference between observation group and routine treatment group(P<0.01).There was no significant difference in calories and protein intake at 9 days after birth between observation group and control group(P>0.05).The accumulation lose of calories and protein in observation group at 3,9 and 21 days after birth were obviously lower than those in routine treatment group,and there was significant difference(P<0.01).The time to regain birth weight in observation group was obviously shorter than that in routine treatment group,and there was significant difference(P <0.01).The growth of head circumference and body height in observation group were faster than those in routine treatment group,and there was significant difference(P <0.05).There was no significant difference in the incidence of complications between two groups.[Conclusion]VLBWIs have good tolerance to early parenteral nutrition.The weight gain is fast,and the time to reach full enteral feeding is shortened,and parenteral nutrition-related compli-cations are not increased.