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接受骨髓移植的儿童的肠外营养并发症

Parenteral Nutrition Complications in Children Undergoing Bone Marrow Transplantation.

作者信息

Soussi Mohamed A, Besbes Habib, Mellouli Fethi, Drira Chema, Lazreg Olfa, Belghith Asma, Zouari Bechir, Zaouali Selima, Bejaoui Mohamed, Razgallah Khrouf Myriam

机构信息

Pharmacy Department.

Faculty of Pharmacy of Monastir.

出版信息

J Pediatr Hematol Oncol. 2019 Oct;41(7):e473-e477. doi: 10.1097/MPH.0000000000001560.

Abstract

BACKGROUND

Parenteral nutrition (PN) seems to be a practical solution to face the negative nutritional effects of bone marrow transplantation.

OBJECTIVE

Report and describe all observed PN-related complications in children undergoing allogenic bone marrow transplantation in a tertiary center and determine the possible risk factors.

MATERIALS AND METHODS

This was a retrospective and observational study including 51 allografted children 2 to 17 years of age. We collected from medical patient records any noticed PN-related complications using an assessment causality method. The independent risk factors for complications were investigated by multivariate analysis.

RESULTS

A total of 92% of patients (n=47) developed a total of 136 complications attributable to PN. The incidence rate of complications was 5 for 100 patient days of PN. Infectious complications (32.3%) and electrolytic disorders (27.9%) were the most common conditions identified during our study. Multivariate analysis showed that the duration of PN exposure, age, and hyperglycemia were the risk factors for the onset of these complications.

CONCLUSIONS

Although we have noticed multiple complications attributable to PN, a certain causal link is difficult to establish in this particular context. Emphasizing enteral nutrition in bone marrow graft protocols would be the best way to avoid these complications.

摘要

背景

肠外营养(PN)似乎是应对骨髓移植负面营养影响的一种切实可行的解决方案。

目的

报告并描述在一家三级中心接受异基因骨髓移植的儿童中所有观察到的与PN相关的并发症,并确定可能的风险因素。

材料与方法

这是一项回顾性观察研究,纳入了51名年龄在2至17岁的接受同种异体移植的儿童。我们使用评估因果关系的方法从医疗患者记录中收集任何注意到的与PN相关的并发症。通过多变量分析研究并发症的独立风险因素。

结果

共有92%的患者(n = 47)出现了总共136例归因于PN的并发症。每100个PN患者日的并发症发生率为5例。感染性并发症(32.3%)和电解质紊乱(27.9%)是我们研究中最常见的情况。多变量分析表明,PN暴露持续时间、年龄和高血糖是这些并发症发生的风险因素。

结论

尽管我们注意到了多种归因于PN的并发症,但在这种特定情况下很难建立确切的因果联系。在骨髓移植方案中强调肠内营养将是避免这些并发症的最佳方法。

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