标题：极低出生体重儿长期胃肠外营养相关性胆汁淤积的发生率及防治

      作者：黄 河，何爱兰，唐碧莲，谢红忠，古晓琳
    （深圳市福田人民医院儿科，广东 深圳 518033）

      卷次： 2012年23卷11期

      【摘要】 目的 研究极低出生体重儿长期胃肠外营养相关性胆汁淤积的发生率及防治措施。方法 选择
2006年1月至2010年6月在本院新生儿科住院并采用胃肠外静脉营养14 d以上的极低出生体重儿共47例，分为
发生新生儿肠外营养相关性胆汁淤积(PNAC)及未发生PNAC两组，进行单因素及多因素Logistic回归模型分
析。结果 PNAC的发生率为 17.02 %。条件 logistic回归分析显示达到全肠道营养时间、PN持续时间、开始胃
肠喂养时间、葡萄糖积累用量、氨基酸积累用量、脂肪积累用量与PNAC密切相关，PN持续时间是独立高危因素
（OR=3.812，95%CI: 0.039~4.027, P=0.012)。结论 PN持续时间越长、PN氨基酸的累积用量越大、PN脂肪乳累
积用量越大、达到全肠道营养的时间越长，则发生PNAC的几率越大。尽早开始肠内营养，避免静脉摄入高热
卡，为降低PNAC的重要措施。

      【关键词】 极低出生体重儿；胃肠外营养；胆汁淤积；发生率

      【中图分类号】 R714.51 【文献标识码】 A 【文章编号】 1003—6350（2012）11—017—04<

br>Incidence and prevention of parenteral nutrition-associated cholestasis in infants with very low birth weight.
HUANG He, HE Ai-lan, TANG Bi-lian, XIE Hong-zhong, GU Xiao-lin.
Department of Pediatrics, People’s Hospital of
Futian District of Shenzhen City, Shenzhen 518033, Guangdong, CHINA

【Abstract】 Objective To study the incidence and prevention of parenteral nutrition-associated cholestasis
(PNAC) in infants with very low birth weight (VLBW). Methods From Jan. 2006 to Jun. 2010, 47 infants with
VLBW were given parenteral nutyition (PN) for more than 14 days in the Department of Pediatrics in our hospital.
They were divided into two groups: with PNAC or without PNAC. Logistic regression analysis were performed. Re-
sults The incidence of PNAC was 17.02 %. Logistic regression analysis showed that time to establish enteral nutri-
tion, PN duration, initial time of enteral feeding, glucose accumulation dosage, amino acids accumulate dosage, fat
milk accumulate amount are closely related to PNAC. PN duration was the independent high risk factors (OR =3.812,
95% CI 0.039~4.027,P = 0.012). Conclusion The incidence of PNAC increased as the increase of the cumulative
amount of PN amino acid, the cumulative amount PN fat emulsion, the time of attaining full intestinal nutrients, the
·临床研究·doi:10.3969/j.issn.1003-6350.2012.11.007