Comparative analysis of the incidence factors of parenteral nutrition associated cholestasis in premature infants of different gestational ages
Objective To analyze the common and specific characteristics of parenteral nutrition associated cholestasis(PNAC),and to develop corresponding prevention and treatment measures for this disease according to the pathogenic factors of this disease in premature infants of different gestational ages.Methods 449 premature infants who received parenteral nutrition(PN)support for more than 14 days were retrospectively selected and divided into ultra premature and extremely premature infants(n=196)and mid and late term premature infants(n=253)according to gestational age.These premature infants were divided into the PNAC group and the non PNAC group based on whether the research subjects had cholestasis.The clinical data of ultra premature and extremely premature infant and mid and late term premature infant were compared separately,and the risk factors for the occurrence of PNAC in ultra premature and extremely premature infant,and mid and late term premature infant were analyzed,and the differences and connections in the pathogenic factors of PNAC between ultra premature and extremely premature infant and mid and late term premature infant were compared.Results Among 449 premature infants,116 cases developed PNAC,with an incidence of 25.84%.Among them,the incidence of PNAC in ultra premature and extremely premature infants was 36.73%,and the incidence in mid and late term premature infants was 17.00%.The common risk factors for PNAC included the duration of continuous use of amino acids,fat emulsion,and glucose in PN,cumulative glucose dose,PN calorie intake,length of hospital stay,timing of initiation of enteral feeding,incidence of feeding intolerance,and duration of periperally inserted central catheter(PICC);Different risk factors included fasting time,milk opening time,duration of ventilator,and incidence of sepsis in ultra premature and extremely premature infants,and necrotizing enterocolitis in newborns and steroid use rate in mid and late term premature infants,while gestational age,birth weight,and probiotic use rate were protective factors for PNAC in mid and late term premature infants,and there was statistically significant difference between the PNAC group and the non PNAC group(P<0.05).Conclusion The longer the fasting time,the higher the incidence of infection;The longer the PN usage time,the higher the cumulative glucose dose and PN calorie intake,and the higher the probability of PNAC occurrence.Effective perinatal care,reduction of premature birth,early initiation of enteral nutrition,shortening of PN support time,and prevention and treatment of infections are important measures to reduce PNAC.
万方数据
维普
