接受胃肠外营养的德国儿童的身体发育和相关并发症

作     者：Wenning D. Lenhartz H. Leichsenring M. Nützen-adel W. 王经纬 

作者机构：Universitatskinderklinik Heidelberg INF 150 69120 Heidelberg Germany Dr. 

出 版 物：《世界核心医学期刊文摘(儿科学分册)》 (Dkgest of the World Latest Medical Information)

年 卷 期：2005年第11期

页      面：62-62页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100404[医学-儿少卫生与妇幼保健学] 10[医学] 

摘      要：Somatic development and rate of complications were studied prospectively in 25 patients receiving long-term parenteral nutrition in 14 German hospitals. For 12 months (3-20) the following data were collected at the beginning, in the middle, and at the end of the study: diagnosis, age at beginning of parenteral nutrition, complications, height, weight, growth velocity and body mass index (BMI), as well as transaminases and bilirubin levels. Catheter-associ-ated complications were observed once per year and patient (mechanical 0.46, septic 0.39, and thrombotic 0.15). At the beginning (and at the end)-of the study period 10 patients (12) had normal liver function (group N), 8 patients (6) showed hepatopathy (group H), and 6 (3) patients exhibited hepatopathy with hyperbilirubinemia (group HB). Four patients were weaned from parenteral nutrition. The median (25th/75th percentile) of SDS for height and BMI at beginning in group HB were -5.3 (-8.5/-4.3) and -2.9 (-3.6/0.1), in group H -2.4 (-4.5/-0.7) and 0.1 (2.3/0.5), and in group N -2.15 (-3.2/-2.0) and -0.9 (-1.8/0.4). The SDS for height velocity were -0.7 (-4.0/0.4), -2.35 (-3.6/-1.0), and -1.1 (-2.9/2.8) in groups HB, H, and N, respectively. Only in group HB with a high percentage of parenterally provided calories did SDS for height (-3.6; -4.5/-2.2) and BMI (0.5; -1.5/1.6) improve significantly (p 0.05). Rates of complications are comparable to published results. The somatic development of our patients is unsatisfying, likely due to inadequate nutrition. Parenteral nutrition only provides certain amounts of the total requirements and it might be possible that oral intake of nutrients or their intestinal absorption is lower than assumed.