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目的探讨传统肠道外营养(TTPN)与早期肠道外营养(ETPN)的不同效果。方法2000年1月至2008年4月我院收治的生后24 h内入院的极低出生体重早产儿,2006年以前入院为TTPN组,2006年以后入院为ETPN组。TTPN组出生24 h后给予氨基酸0.5 g·kg~(-1)·d~(-1),每日递增0.25～0.5g/kg,出生第3天给予脂肪乳0.5 g·kg~(-1)·d~(-1),每日递增0.25～0.5g/kg;ETPN组出生12～24 h给予氨基酸1.0 g·kg~(-1)·d~(-1),每日递增0.5 g/kg,出生24 h给予脂肪乳0.5～1.0 g·kg~(-1)·d~(-1),每日递增0.5 g/kg。观察生后1周内非蛋白热卡(不计奶量),生理性体重下降时间、恢复至出生体重时间、体重增长情况、过渡至全肠道营养时间及相关并发症等。结果共入选58例,TTPN组30例,ETPN组28例。ETPN组较TTPN组非蛋白热卡摄入多,体重下降持续时间短,恢复至出生体重时间短,体重增长快,差异有统计学意义(P<0.05);后期相关并发症及过渡至全肠道外营养时间差异无统计学意义(P>0.05)。结论极低出生体重早产儿ETPN比TTPN摄入热量多,体重增长快,可以减少早期营养不良发生,肠道外营养相关并发症无明显增加,对胃肠功能的恢复无明显影响。
Objective To explore the different effects of traditional parenteral nutrition (TTPN) and early parenteral nutrition (ETPN). Methods Preterm infants with very low birth weight admitted to our hospital from January 2000 to April 2008 within 24 hours after birth were admitted to TTPN group before 2006 and ETPN group after 2006. TTPN group was given 0.5 g · kg -1 d -1 at 24 h after birth and increased by 0.25-0.5 g / kg daily. On the third day after birth, 0.5 g · kg -1 ) · D ~ (-1), increasing 0.25 ~ 0.5g / kg daily. The amino acids 1.0g · kg ~ (-1) d ~ (-1) kg per day, 0.5 to 1.0 g · kg -1 d · (-1) of fat emulsion was given 24 hours after birth and increased 0.5 g / kg daily. Observed within 1 week after birth non-protein heat card (excluding milk), physiological weight loss time, to restore weight to birth time, weight gain, transition to the whole intestine nutrition time and related complications. Results A total of 58 patients were enrolled, 30 patients in TTPN group and 28 patients in ETPN group. Compared with TTPN group, ETPN group had more intake of non-protein calorie, weight loss duration was shorter, weight to body weight returned to birth weight shortened, weight gain was faster, the difference was statistically significant (P <0.05); late-stage complications and transition to the whole intestine There was no significant difference in nocturnal nutrition time (P> 0.05). Conclusion Very low birth weight preterm infants ETPN than TTPN intake of calories and weight gain faster, can reduce the incidence of early malnutrition, no significant increase in complications of parenteral nutrition, no significant effect on the recovery of gastrointestinal function.