Törer Birgin, Hanta Deniz, Özdemir Zeliha, Çetinkaya Bilin, Gülcan Hande
Neonatology Unit, Department of Pediatrics, Başkent University Faculty of Medicine, Adana, Turkey.
Turk J Pediatr. 2015 May-Jun;57(3):236-41.
The objective of this study was to compare postnatal growth and clinical outcomes of preterm infants after an adjustment in amino acid and lipid administration practice. The study was conducted retrospectively in preterm infants with a birth weight < 1250 g for the periods January-June 2007 and June-November 2010. In 2007, amino acid solution was initiated at 2 g/kg/ day on the first day of life and advanced 1 g/kg/day to a maximum of 3 g/kg/day; lipid solution was initiated at 1 g/kg/day on the first day of life and advanced 0.5 g/kg/day to a maximum of 2 g/kg/day (low-dose parenteral nutrition group). In 2010, amino acid solution was initiated at 3 g/kg/day on the first day of life and advanced 1 g/kg/day to a maximum of 4 g/kg/ day; lipid solution was initiated at 1 g/kg/day on the first day of life and advanced 1 g/kg/day to a maximum of 3 g/kg/day (high-dose parenteral nutrition group). Patient characteristics were similar in the two groups. Infants in the high-dose parenteral nutrition group showed a significant reduction in the time needed to regain birth weight and a significant reduction in the maximum weight loss. Weight, length and head circumference at discharge were significantly higher in the high-dose parenteral nutrition group. The mean duration of parenteral nutrition, mean number of days to reach full enteral feeding and incidence of sepsis and necrotizing enterocolitis were significantly lower in the high-dose parenteral nutrition group. There was no significant difference in the mortality rate between the groups. In conclusion, a more aggressive parenteral nutrition protocol for preterm infants resulted in a more rapid increase in weight, length and head circumference, and decreased incidence of sepsis and necrotizing enterocolitis.
本研究的目的是比较调整氨基酸和脂质给药方案后早产儿的出生后生长情况及临床结局。该研究对2007年1月至6月和2010年6月至11月期间出生体重<1250 g的早产儿进行了回顾性研究。2007年，氨基酸溶液于出生第一天以2 g/kg/天开始，每天增加1 g/kg，最大剂量为3 g/kg/天；脂质溶液于出生第一天以1 g/kg/天开始，每天增加0.5 g/kg，最大剂量为2 g/kg/天（低剂量肠外营养组）。2010年，氨基酸溶液于出生第一天以3 g/kg/天开始，每天增加1 g/kg，最大剂量为4 g/kg/天；脂质溶液于出生第一天以1 g/kg/天开始，每天增加1 g/kg，最大剂量为3 g/kg/天（高剂量肠外营养组）。两组患者的特征相似。高剂量肠外营养组的婴儿恢复出生体重所需时间显著缩短，最大体重减轻也显著减少。高剂量肠外营养组出院时的体重、身长和头围显著更高。高剂量肠外营养组的肠外营养平均持续时间、达到完全肠内喂养的平均天数、败血症和坏死性小肠结肠炎的发生率显著更低。两组之间的死亡率无显著差异。总之，更积极的早产儿肠外营养方案导致体重、身长和头围增加更快，败血症和坏死性小肠结肠炎的发生率降低。
