中国儿童保健杂志 ›› 2016, Vol. 24 ›› Issue (8): 807-809.DOI: 10.11852/zgetbjzz2016-24-08-07

• 科研论著 • 上一篇    下一篇

静脉营养中不同初始剂量氨基酸对早产儿早期营养的影响

谈健民,郑玉琼,万鸿,罗天宽,申川桥,杨莉娜   

  1. 四川省乐山市妇幼保健院,四川 乐山 614000
  • 收稿日期:2016-03-03 发布日期:2016-08-10 出版日期:2016-08-10
  • 通讯作者: 郑玉琼,E-mail:864069461@qq.com
  • 作者简介:谈健民(1961-),男,四川人,主任医师,本科学历,主要研究方向为早产儿管理。
  • 基金资助:
    四川省乐山市科技局科研资助项目(14SZD150)

Influence of early different doses of intravenous amino acid supplementation on preterm infants' nutrition.

TAN Jian-min,ZHENG Yu-qiong,WAN Hong,LUO Tian-kuan,SHEN Chuan-qiao,YANG Li-na.   

  1. Maternal and Child Health Care Hospital of Leshan City,Leshan,Sichuan 614000,China
  • Received:2016-03-03 Online:2016-08-10 Published:2016-08-10
  • Contact: ZHENG Yu-qiong,E-mail:864069461@qq.com

摘要: 目的 探讨静脉使用不同剂量氨基酸对早产儿早期营养的影响。方法 将接受静脉营养的146例早产儿(胎龄29~34周,出生体重1 150~2 250 g)随机分为3组,大剂量组于生后24 h内给予氨基酸2.0 g/(kg·d),每日递增1.0 g/(kg·d);中剂量组给予氨基酸1.0 g/(kg·d),每日递增0.5 g/(kg·d);小剂量组给予氨基酸0.5 g/(kg·d),每日递增0.5 g/(kg·d);三组最大剂量均为3.5 g/(kg·d)。对三组患儿进行有效性评估和生化、血气指标检测比较。结果 三组结果比较,其中大剂量组恢复至出生体重的时间最短;出生2周内大剂量组每天体重增长速度最快;大剂量组肠道营养达到100 kCal/kg天数较中剂量组和小剂量组短。差异有统计学意义(P<0.05)。三组早产儿第14天时肾功能尿素氮、肌酐、pH值、剩余碱、血清直接胆红素和总胆汁酸水平比较,各组间差异均无统计学意义(P>0.05)。结论 早期应用大剂量氨基酸更有利于早产儿的营养和生长发育,并且不会增加代谢性酸中毒、肾功能损害、胆汁淤积症等不良后果的发生。

关键词: 氨基酸, 静脉营养, 生长发育, 早产儿

Abstract: Objective To assess the effectiveness of early different doses of intravenous amino acid supplementation in preterm infants. Methods According different intravenous amino acid administration,one hundred and forty-six preterm infants (fetal age 29~34,birth weight 1 150~2 250 g) were randomly divided into low dose,median dose,high dose groups.The infants in high dose group were treated with amino acid 2.0 g/(kg·d) within 24 hours,increasing by 1.0 g per day;The median dose group was treated with amino acid 1.0g/(kg·d),increasing by 0.5 g per day;The low dose group was treated with amino acid 0.5 g/(kg·d),increasing by 0.5 g per day. Results The time of rebounding to birth weigh in the high dose group was less than that in the median and low dose group;In two weeks after birth,the rate of weight again in the high dose group was highest than that in other dose groups;In the high dose group,time of achieving enteral nutrition of 100 kCal/kg days was lower than that in other dose groups (P<0.05).On the fourteenth day after birth,there was no significant difference in urea nitrogen,creatinine,PH value,base excess,serum bilirubin and total bile acid among the three groups (P>0.05). Conclusion Early higher doses of amino acid supplementation is beneficial to preterm infants' early growth and nutrition with little incidence of metabolic acidosis,renal dysfunction or cholestasis.

Key words: amino acid, intravenous nutrition, growth and development, preterm infant

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