2025 年第 4 期 第 20 卷

早产儿标准化静脉营养配方临床应用效果观察

Observation of clinical application effect of standardized intravenous nutrition formula for preterm infants

作者：王天成1李世红2郑海亮1王杨1邢桂荣1李莉1朱露璐1张昊1张莉1刘娅1

英文作者：Wang Tiancheng1 Li Shihong2 Zheng Hailiang1 Wang Yang1 Xing Guirong1 Li Li1 Zhu Lulu1 Zhang Hao1 Zhang Li1 Liu Ya1

单位：1首都医科大学附属北京世纪坛医院新生儿科，北京100038；2首都医科大学附属北京朝阳医院呼吸内科，北京100043

英文单位：1Department of Neonatology Beijing Shijitan Hospital Capital Medical University Beijing 100038 China; 2Department of Respiratory Beijing Chao-Yang Hospital Capital Medical University Beijing 100043 China

关键词：标准化静脉营养；早产儿；左卡尼汀；胆汁淤积；支气管肺发育不良

英文关键词：Standardizedintravenousnutrition;Preterminfants;L-carnitine;Cholestasis;Bronchopulmonarydysplasia

• 摘要：

• 目的 观察早产儿标准化静脉营养配方临床应用效果。方法 选取2015年7月至2020年3月首都医科大学附属北京世纪坛医院住院的162例需要肠外营养的早产儿参与本研究。按照随机数字表法分为常规液组（80例）和标准液组（82例），分别接受个体化静脉营养配方和加用左卡尼汀的标准化静脉营养配方治疗。比较2组患儿一般资料、出生后6周临床情况及胆汁淤积、支气管肺发育不良、颅内出血、早产儿视网膜病等不良事件发生情况。结果 治疗2周后标准液组体重增长量大于常规液组［（151±92）g比（110±78）g］，差异有统计学意义（P=0.003）。出生后6周标准液组直接胆红素、胆汁酸水平均低于常规液组［（18±10）μmol/L比（26±15）μmol/L、（53±27）μmol/L比（77±24）μmol/L］，差异均有统计学意义（均P<0.001）。孕周36周时，标准液组支气管肺发育不良发生率低于常规液组［12.2%（10/82）比27.5%（22/80）］（P<0.05），而2组颅内出血和早产儿视网膜病的发生率差异均无统计学意义（均P>0.05）。结论 与接受个体化静脉营养配方相比，接受标准化静脉营养的早产儿2周后体重增长优于前者，使用加入左卡尼汀的标准化静脉营养配方有利于减轻早产儿胆汁淤积程度；使用标准化静脉营养有利于减少早产儿支气管肺发育不良的发生，2组发生颅内出血、早产儿视网膜病无明显差别。

• Objective To observe the clinical effect of standardized intravenous nutrition formula in premature infants. Methods A total of 162 premature infants who needed parenteral nutrition and were hospitalized in Beijing Shijitan Hospital, Capital Medical University from July 2015 to March 2020 were enrolled in this study. According to the random number table method, they were divided into conventional solution group (80 cases) and standard solution group (82 cases). They were treated with individualized intravenous nutrition formula and standard intravenous nutrition formula with added L-carnitine, respectively. The two groups were compared in terms of general data, clinical conditions at 6 weeks after birth, and the incidence of such as cholestasis, bronchopulmonary dysplasia, intracranial hemorrhage, and retinopathy of prematurity. Results After 2 weeks of treatment, the weight gain of the standard solution group was greater than that of the conventional solution group［(151±92)g vs (110±78)g］(P=0.003). At 6 weeks after birth, the levels of direct bilirubin and bile acid in the standard solution group were lower than those in the conventional solution group［(18±10)μmol/L vs (26±15)μmol/L, (53±27)μmol/L vs (77±24)μmol/L］(both P<0.001). At 36 weeks of gestation, the incidence of bronchopulmonary dysplasia was lower in the standard solution group than in the conventional solution group［12.2%(10/82) vs 27.5%(22/80)］(P<0.05). There was no significant difference in the incidence of intracranial hemorrhage and retinopathy of prematurity between the two groups(both P>0.05). Conclusion Compared with individualized intravenous nutrition prescription, the weight gain of premature infants receiving standardized intravenous nutrition formula is better after 2 weeks. The use of standardized intravenous nutrition formula with L-carnitine is beneficial to reduce the degree of cholestasis in premature infants. The use of standardized intravenous nutrition is beneficial to reduce the incidence of bronchopulmonary dysplasia in preterm infants. There is no significant difference in the incidence of intracranial hemorrhage and retinopathy of prematurity between the two groups.