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目的观察新生儿胃肠外营养相关性胆汁淤积(PNAC)的发生率及其影响因素。方法对2007年1月-2008年12月本院新生儿科胃肠外营养(PN)≥14d的98例新生儿进行临床分析。按PNAC的有无分组并进行临床资料(一般情况、PN相关指标)比较,计量资料用t检验,计数资料用χ2检验,危险因素以单因素及多因素Logistic回归模型进行分析。P<0.05为差异有统计学意义。结果PN≥14d的98例新生儿中,发生PNAC8例,发生率为8.16%。PN持续时间、氨基酸累积用量、脂肪累积用量、达到全胃肠道营养的时间与PNAC密切相关,胎龄<30周、感染在2组间差异均有统计学意义(Pa<0.05);氨基酸累积用量是PNAC发生的独立危险因素(OR=1.037,95%CI:1.004～1.071,P=0.004)。结论PN、氨基酸累积用量、脂肪累积用量、达到全胃肠道营养的时间可能是影响新生儿PNAC发生的因素,其中氨基酸累积用量可能是PNAC发生的独立危险因素。
Objective To observe the incidence of neonatal parenteral nutrition-related cholestasis (PNAC) and its influencing factors. Methods From January 2007 to December 2008, 98 cases of neonates with neonates with parenteral nutrition (PN) ≥14 days were enrolled in this study. According to the presence or absence of PNAC grouping and clinical data (in general, PN-related indicators), measurement data using t test, count data usingχ2 test, risk factors by single factor and multivariate Logistic regression model analysis. P <0.05 for the difference was statistically significant. Results PN98 occurred in 98 newborns with PN≥14d, the incidence was 8.16%. PN duration, cumulative amount of amino acids, fat accumulation, time to achieve total gastrointestinal nutrition and PNAC closely related to gestational age <30 weeks, the infection in the two groups were statistically significant differences (Pa <0.05); amino acid accumulation The dose was an independent risk factor for PNAC (OR = 1.037, 95% CI: 1.004-1.07 I, P = 0.004). Conclusions PN, accumulation of amino acids, accumulation of fat, and time of total gastrointestinal nutrition may be the factors influencing the occurrence of PNAC in neonates. The cumulative amount of amino acids may be an independent risk factor for PNAC.