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目的分析早产儿胆汁淤积的临床及随访情况,为合理诊治及随访提供依据。方法对2010年1月-2014年6月湖南省儿童医院收住入院的1 894例早产儿进行筛查,73例达到胆汁淤诊断标准,对这73例进行回顾性分析。并按有无肠外营养相关胆汁淤积(PNAC)分组,对两组资料进行比较,并对危险因素进行分析。结果早产儿淤胆病因中PNAC56例(76.71%),全身感染11例(15.07%),胆道闭锁1例(1.37%),其它原因5例(6.85%)。PNAC组和无PNAC组临床资料比较:住院天数、PN持续时间、全静脉营养时间、氨基酸总量、脂肪乳总量之间的差异均有统计学意义(P<0.05)。PN持续时间、氨基酸总量、脂肪乳总量是PNAC的危险因素。早产儿胆汁淤积的治愈和好转率是94.52%(69/73)。放弃治疗4例,出院后4例均死亡。结论早产儿胆汁淤积病因繁多,相对而言,除PNAC外,胆汁淤积的病因更为复杂。早产儿胆汁淤积经治疗,疗效显著。
Objective To analyze the clinical and follow-up of cholestasis in preterm infants and provide the basis for proper diagnosis and follow-up. Methods A total of 1 894 premature infants admitted to Hunan Children’s Hospital from January 2010 to June 2014 were screened and 73 cases were diagnosed as cholestasis. The 73 cases were retrospectively analyzed. And according to whether there is parenteral nutrition associated cholestasis (PNAC) grouping, the two groups of data were compared and the risk factors were analyzed. Results Among the etiopathogenisis in preterm infants, PNAC was found in 56 cases (76.71%), systemic infection in 11 cases (15.07%), biliary atresia in 1 case (1.37%) and in other causes in 5 cases (6.85%). The clinical data of PNAC group and non-PNAC group were statistically significant (P <0.05). There was significant difference between the days of hospitalization, PN duration, total parenteral nutrition time, total amino acids and total fat emulsion. PN duration, total amino acids, total fat emulsion is a risk factor for PNAC. The cure and improvement rate of premature cholestasis was 94.52% (69/73). Give up treatment in 4 cases, 4 cases were discharged after death. Conclusion There are many causes of cholestasis in preterm infants. Relatively speaking, the cause of cholestasis is more complicated than PNAC. Premature cholestasis by treatment, the effect is significant.