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目的探讨早期静脉营养支持对先天性心脏病术后低体重患儿的治疗效果,并分析血清内皮素(ET-1)水平和心功能在营养支持前后的变化情况。方法选取2014年1-12月在该院行手术治疗的低体重先天性心脏病患儿150例,随机分为观察组和对照组,每组各75例。观察组采用早期全静脉营养支持治疗,对照组采用常规静脉营养支持治疗,比较两组患儿的一般资料、治疗前与治疗后的营养状况、心功能及ET-1水平的差异。结果两组患儿一般资料,治疗前、治疗后的营养状况比较,差异无统计学意义(P>0.05)。治疗前,两组患儿心功能以及ET-1水平比较,差异无统计学意义(P>0.05);治疗后,观察组患者的左室收缩末前后径(LVESD)、左室舒张末前后径(LVEDD)以及ET-1水平均显著低于对照组(P<0.05),而每搏输出量(SV)和射血功能(EF)显著高于对照组(P<0.05)。结论早期全静脉营养支持可以有效改善低体重先天性心脏病患儿手术后的营养状态、心功能及ET-1水平,值得临床推广应用。
Objective To investigate the effect of early intravenous nutritional support on children with postoperative low birth weight in congenital heart disease and to analyze the changes of serum endothelin (ET-1) and cardiac function before and after nutrition support. Methods A total of 150 children with congenital heart disease of low birth weight who underwent surgery in our hospital from January to December 2014 were randomly divided into observation group and control group, with 75 cases in each group. The observation group received early total parenteral nutrition support. The control group received routine parenteral nutrition support. The general data, nutritional status, cardiac function and ET-1 level before and after treatment were compared between the two groups. Results The general data of two groups of children, before and after treatment of nutritional status, the difference was not statistically significant (P> 0.05). Before treatment, there was no significant difference in cardiac function and ET-1 levels between the two groups (P> 0.05). After treatment, the left ventricular end systolic diameter (LVESD), left ventricular end-diastolic anteroposterior diameter (LVEDD) and ET-1 levels were significantly lower than those of the control group (P <0.05), and stroke volume (SV) and ejection function (EF) were significantly higher than those of the control group (P <0.05). Conclusion Early total parenteral nutritional support can effectively improve nutritional status, cardiac function and ET-1 level in children with low birth weight congenital heart disease, which is worthy of clinical application.