积极肠外营养支持方案在胎龄小于34周早产儿中的远期效果研究

doi:10.7499/j.issn.1008-8830.2108113

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摘要目的探讨应用积极肠外营养支持方案在胎龄小于34周早产儿肠外营养中的远期疗效。方法根据早期应用脂肪乳和氨基酸剂量的不同，将2019年5~12月收治的生后24 h内入院、胎龄小于34周的早产儿分为积极肠外营养组和常规肠外营养组，每组各50例，分别收集两组早产儿在随访6个月和13个月时的体格指标及Gesell发育量表测定值。结果 6月龄时，积极肠外营养组早产儿（n=46）在大运动、精细运动、个人-社会性行为3个能区的发育商均显著高于常规肠外营养组（n=34）（P<0.05）；13月龄时，积极肠外营养组早产儿（n=25）在适应性行为、大运动、个人-社会性行为3个能区的发育商均显著高于常规肠外营养组（n=19）（P<0.05）。两组患儿在整个随访过程中的体重、身长、头围等体格发育指标差异均无统计学意义（P>0.05）。结论在生后24 h内给予胎龄小于34周早产儿含高剂量脂肪乳和氨基酸的积极肠外营养支持策略可显著改善其远期神经系统发育。

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	蒋仁荟
	申玉洁
	刘晓晨
	李禄全
	程茜

关键词 ：肠外营养, 氨基酸, 脂肪乳, 神经系统发育, 早产儿

Abstract：Objective To study the long-term effect of active parenteral nutrition support regimen in preterm infants with a gestational age of <34 weeks. Methods According to the different doses of fat emulsion and amino acids used in the early stage, the preterm infants with a gestational age of <34 weeks, who were admitted to the hospital within 24 hours after birth from May to December 2019, were divided into an active parenteral nutrition group and a conventional parenteral nutrition group (n=50). Physical indices and the measurements of the Gesell Development Scale were collected at the age of 6 months and 13 months. Results At the age of 6 months, the active parenteral nutrition group (n=46) had higher developmental quotients of gross motor, fine motor, and personal-social behavior than the conventional parenteral nutrition group (n=34) (P<0.05). At the age of 13 months, the active parenteral nutrition group (n=25) had higher developmental quotients of adaptive behavior, gross motor, and personal-social behavior than the conventional parenteral nutrition group (n=19) (P<0.05). There were no significant differences in the physical development indices such as body weight, body height, and head circumference between the two groups during follow-up (P>0.05). Conclusions For preterm infants with a gestational age of <34 weeks, an active parenteral nutrition support strategy with high doses of fat emulsion and amino acids within 24 hours after birth can improve their long-term neurodevelopment.

Key words： Parenteral nutrition Amino acid Fat emulsion Neurodevelopment Preterm infant

收稿日期: 2021-08-23

基金资助:重庆市人力资源和社会管理局回国人员创业创新计划项目（cx2017107）。

通讯作者: 程茜，女，教授。Email：chqq5@126.com。 E-mail: chqq5@126.com

作者简介: 蒋仁荟，女，硕士研究生，住院医；

引用本文:

蒋仁荟,申玉洁,刘晓晨等. 积极肠外营养支持方案在胎龄小于34周早产儿中的远期效果研究[J]. 中国当代儿科杂志, 2021, 23(12): 1221-1227.

JIANG Ren-Hui,SHEN Yu-Jie,LIU Xiao-Chen et al. Long-term effect of active parenteral nutrition support regimen in preterm infants with a gestational age of <34 weeks[J]. CJCP, 2021, 23(12): 1221-1227.

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http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2108113 或 http://www.zgddek.com/CN/Y2021/V23/I12/1221

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