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目的 :探讨血氨检测在早产儿胃肠外营养安全评估的价值,为早产儿早期营养支持与诊治提供临床检测依据。方法 :随机选取2012年7月1日~2014年6月30日在我院妇产科出生后24小时内需胃肠外营养的早产儿56例作为实验组,选取同期出生的24例无需胃肠外营养的早产儿作为对照组。对照组患儿给予早产儿配方奶粉或母乳喂养,实验组给予等量的胃肠外营养支持。分别测定两组早产儿治疗前、治疗后2d、7d及出院时的血氨、尿素氮、胆红素和前白蛋白等生化指标数据,比较实验组与对照组早产儿治疗期间的血氨水平变化差异。结果 :两组早产儿治疗前临床资料无明显差异,治疗后第2天实验组与对照组早产儿生化指标中血氨水平和胆红素出现显著统计学差异;治疗第7天实验组与对照组早产儿生化指标中血氨水平和尿素氮指标有显著性差异。在患儿出院时实验组与对照组早产儿的血氨、尿素氮、前白蛋白、胆红素等生化指标均无明显差异。结论 :早产儿胃肠外营养支持与母乳喂养早产儿的血氨指标具有明显的差异,可将血氨检测作为早产儿胃肠外营养支持安全评估的评价指标。
Objective: To investigate the value of serum ammonia in the evaluation of parenteral nutrition safety in premature infants and to provide the basis for clinical diagnosis of early nutritional support and diagnosis. Methods: From July 1, 2012 to June 30, 2014, 56 cases of preterm infants requiring parenteral nutrition within 24 hours after birth in our hospital were selected as the experimental group. Twenty-four of those born in the same period were selected without gastrointestinal External nutrition of premature children as a control group. The control group gave preterm infant formula or breastfeeding, and the experimental group received the same amount of parenteral nutrition support. Blood biochemical parameters such as serum ammonia, urea nitrogen, bilirubin and prealbumin before treatment, 2d, 7d after treatment and before discharge were measured in two groups respectively. The levels of serum ammonia in the experimental group and the control group during treatment Variation. Results: There was no significant difference in the clinical data of preterm infants between the two groups before treatment. On the second day after treatment, the levels of serum ammonia and bilirubin were significantly different between the experimental group and the control group. On the 7th day, the experimental group and the control group Pre-term biochemical indicators of blood ammonia and urea nitrogen indicators were significantly different. There was no significant difference in biochemical indexes such as blood ammonia, urea nitrogen, prealbumin, bilirubin in experimental group and control group before discharged from hospital. CONCLUSIONS: There is a clear difference in blood ammonia markers between preterm infants with parenteral nutrition support and breastfeeding preterm infants, which can be used to evaluate the safety of parenteral nutrition support in preterm infants.