早产儿早期静脉营养耐受性的探讨

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目的探讨早产儿生后1-2d对静脉营养的耐受性。方法将不能完全耐受肠道营养的早产儿34例(胎龄29-36周,体重900-1800g),随机分为两组,实验组于生后48h内添加氨基酸及脂肪乳;对照组采用传统的静脉营养方法,即生后第3天应用氨基酸,第5天应用脂肪乳,同时均根据病情尽早经口微量喂养。两组患儿均于生后第1天及第7天采血,监测血清游离脂肪酸、总胆红素、直接胆红素、白蛋白、甘油三脂、总胆固醇,每天监测体重、微量血糖及经皮胆红素值。比较两组患儿恢复出生体重的时间、血清游离脂肪酸、胆红素及血脂的变化。结果1)实验组患儿恢复出生体重的时间较对照组短;2)两组患儿生后相同日龄测得血清游脂肪酸、总胆红素、直接胆红素、甘油三脂、总胆固醇及血清游离脂肪酸与白蛋白的摩尔比均无显著差异。结论早产儿生后1-2d可耐受全或部分肠道外营养。 Objective To investigate the tolerance of intravenous nutrition to premature infants 1-2 days after birth. Methods 34 cases of preterm infants (gestational age 29-36 weeks, body weight 900-1800g) who could not fully tolerate intestinal nutrition were randomly divided into two groups. The experimental group added amino acids and fat emulsion within 48 hours after birth. The control group The traditional method of intravenous nutrition, that is, amino acids on the 3rd day after birth, fat emulsion on the 5th day, meanwhile oral micro-feeding according to the condition as soon as possible. Blood samples were collected on the first day and the seventh day after birth in both groups. Serum free fatty acid, total bilirubin, direct bilirubin, albumin, triglyceride and total cholesterol were monitored. Body weight, blood glucose, Skin bilirubin value. The recovery time of birth weight, serum free fatty acid, bilirubin and lipids were compared between the two groups. Results 1) The experimental group had shorter birth weight than the control group; 2) The serum total fatty acids, total bilirubin, direct bilirubin, triglyceride, total cholesterol There was no significant difference in the molar ratio of serum free fatty acid to albumin. Conclusion The preterm infants can tolerate all or part of parenteral nutrition 1-2 days after birth.
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