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目的:探讨早期应用高、中、低剂量的氨基酸对早产儿进行营养支持的近期疗效及安全性。方法:选取早产儿99例,按照随机数字表法将患儿分为高剂量组、中剂量组、低剂量组,各33例。3组患儿均在出生24 h内给予氨基酸注射液,ivgtt,其中高剂量组患儿给予3 g/(kg·d),中剂量组患儿给予2 g/(kg·d),低剂量组患儿给予1 g/(kg·d),均逐日增加0.5 g/(kg·d),预期峰值分别为3.5、3.5和3 g/(kg·d)。3组患儿疗程均为28 d。观察3组患儿的健康指标、肾功能指标和血液指标;记录3组患儿并发症和不良反应发生情况。结果:高、低剂量组各脱落2例,高剂量组患儿的住院时间、体质量增至2 500 g的时间和体质量下降率等明显短/低于中、低剂量组,中剂量组明显短/低于低剂量组,差异有统计学意义(P<0.05);高剂量组患儿的肌酐、血剩余碱和血清总胆红素等明显高于中、低剂量组,中剂量组明显高于低剂量组,差异有统计学意义(P<0.05);高剂量组患儿并发症的发生例次(11例次)明显低于中剂量组(20例次)和低剂量组(26例次),差异有统计学意义(P<0.05)。3组患儿均未见明显不良反应发生。结论:早期高剂量的氨基酸静脉营养支持对早产儿营养状态及健康体质的恢复具有促进作用,且耐受性良好,安全性较好。
OBJECTIVE: To explore short-term efficacy and safety of early use of high-dose, medium-dose and low-dose amino acid in premature babies. METHODS: 99 premature babies were selected and randomly divided into high-dose group, medium-dose group and low-dose group, with 33 cases in each group. 3 groups were given Amino acid injection, ivgtt, within 24 h after birth, high-dose group was given 3 g/(kg·d), medium-dose group 2 g/(kg·d) and low-dose group 1 g/(kg·d); those dose increased by 0.5 g/(kg·d) day by day; predicted peak values of them were 3.5, 3.5 and 3 g/(kg·d), respectively. Treatment courses of 3 groups lasted for 28 d. Health indexes, renal function indexes and blood indexes were observed in 3 groups. The occurrence of complications and ADR were recorded in 3 groups. RESULTS: 2 cases withdrew from high-dose and low-dose groups. Hospitalization stay, the time of body weight increasing to 2 500 g and the rate of body weight decreasing in high-dose group were significantly lower or shorter than in medium-dose and low-dose groups; the medium-dose group was significantly lower or shorter than the low-dose group, with statistical significance (P<0.05); the levels of creatinine, residual alkali, serum total bilirubin in high-dose group were significantly higher than medium-dose and low-dose groups, and the medium-dose group was significantly higher than the low-dose group, with statistical significance (P<0.05). The number of complications cases in high-dose group (11 cases) were significantly lower than in medium-dose group (20 cases) and low-dose group (26 cases), with statistical significance (P<0.05). No obvious ADR was found in 3 groups. CONCLUSIONS: High-dose of amino acid intravenous nutrition support in early stage can promote the recovery of nutrition state and healthy constitution in premature babies with good tolerance and safety.
早产儿氨基酸静脉营养近期疗效耐受
Premature babiesAmino acidIntravenous nutritionShort-term efficacyTolerance
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