CAJ | 학술논문

目的：初步了解暨南大学附属第一医院新生儿科全肠外营养液( TPN)的应用情况,为进一步规范TPN使用、制定合适的指南提供参考依据,保证合理安全用药。方法从2012年1月—2013年6月暨南大学附属第一医院新生儿科TPN的处方中,选取胎龄<37周,出生体质量<2500 g、使用TPN≥3 d的早产儿,按出生后≤3 d(n=27)和出生后>3 d(n=28)开始使用TPN进行分组,记录出院时的体质量、恢复出生体质量的天数及TPN使用前、后的各生化指标,并对比分析,以评价两组的疗效和并发症。结果早期组和较晚组对比,使用后的住院时间、使用TPN时间、体质量增长速率、血糖、K+、Ca2+、Cl-、BUN、肌酐和血清胆红素均差异无统计学意义(P>0.05),但早期组恢复出生体质量时间(8.9±5.5) d短于较晚组[(12.5±7.2) d,t=2.29, P<0.05],对血糖影响也差异有统计学意义(P<0.05),两组使用TPN均能较好预防和纠正低血糖、低血钙,而BUN、肌酐、血清胆红素水平无较大异常。结论早期使用TPN可使早产儿获得更好的生长,使用TPN可预防和纠正低血糖和电解质紊乱,但不影响肝肾功能。两组的营养支持均未达到理想状况,需进一步改善。
목적：초보료해기남대학부속제일의원신생인과전장외영양액( TPN)적응용정황,위진일보규범TPN사용、제정합괄적지남제공삼고의거,보증합리안전용약。방법종2012년1월—2013년6월기남대학부속제일의원신생인과TPN적처방중,선취태령<37주,출생체질량<2500 g、사용TPN≥3 d적조산인,안출생후≤3 d(n=27)화출생후>3 d(n=28)개시사용TPN진행분조,기록출원시적체질량、회복출생체질량적천수급TPN사용전、후적각생화지표,병대비분석,이평개량조적료효화병발증。결과조기조화교만조대비,사용후적주원시간、사용TPN시간、체질량증장속솔、혈당、K+、Ca2+、Cl-、BUN、기항화혈청담홍소균차이무통계학의의(P>0.05),단조기조회복출생체질량시간(8.9±5.5) d단우교만조[(12.5±7.2) d,t=2.29, P<0.05],대혈당영향야차이유통계학의의(P<0.05),량조사용TPN균능교호예방화규정저혈당、저혈개,이BUN、기항、혈청담홍소수평무교대이상。결론조기사용TPN가사조산인획득경호적생장,사용TPN가예방화규정저혈당화전해질문란,단불영향간신공능。량조적영양지지균미체도이상상황,수진일보개선。
Objective To investigate how total parenteral nutrition( TPN) is applied in the neonatal units of the first affiliated hospital of Jinan university, provide reference for the standardized use of TPN, formulate appropriate guidelines, and ensure that clinical nutrition is properly and safely used in prenatal patients. Methods Preterm infants with gestational age<37 weeks and birth weights <2 500 g who used TPN in the neonatal units from January 2012 to June 2013 were assigned into two groups, Patients in Group 1 (n=27) began TPN within 3 d after birth, and patients in Group 2 (n=28) began TPN 3 d after birth. Body weight and the time to regain birth weight were obtained at discharge,, and biochemical indexes before and after TPN were also evaluated. Results Compared with late TPN, early TPN significantly reduce the time to regain birth weight[(12. 5± 7. 2) d vs (8. 9±5. 5) d, P<0. 05], and maintained normal blood glucose level (P<0. 05). There were no differences with regards to length of hospitalization, duration of TPN use, growth rate, blood glucose, K+, Ca2+, Cl-, BUN, serum creatinine, BUN and serum bilirubin (all P>0. 05). Both groups can effectively prevent and correct hypoglycemia and hypocalcemia. Conclusion Early TPN can promote growth of preterm infant. The use of TPN can improve hypoglycemia and hypocalcemia without effect on liver and kidney function. Neither group achieved ideal nutritional support outcome and therefore requires further improvement.