| PurposeCongenital intestinal atresia is one of the common surgical gastrointestinal malformations in children. The specific pathogenesis of intestinal atresia is unknown, its incidence is about1/5000, male slightly higher than the female. It is one of the important reasons in neonatal surgical cause of intestinal obstruction, it has been high mortality. Ileum and jejunum is more common, followed by the duodenum, colon rare. The preoperative of Intestinal atresia has serious loss owing to vomiting, body fluids and bowel function recovery and adaptation for a long time, up to1to3weeks, the part of the children suffering from intestinal atresia, accompanied by mesenteric narrow and curled, and even multiple atresia bowel shortening or more serious, and some children with low birth weight because of preterm children, longer recovery time after surgery, at this time, nutritional support is particularly important. In the clinical course of treatment of these children (suffering from intestinal atresia need in digestive tract surgery, not oral feeding newborns), total parenteral nutrition support is used wildly. The purpose of this project is to analyze the more reasonable program after the surgery of neonatal intestinal atresia about infusion of intravenous nutrition to improve the nutritional status. MethodsThe total intestinal atresia are32cases,15cases are of the test group,17cases are of the control group,The program of the test group in the day after the surgery: given amino acid starting dose to1.5g/(kg·d),1.0g/kg increasing day by day, up to the maximum dose of3.5g/(kg·d);The program of the control group in the day after the surgery:given amino acids starting dose of1.0g/(kg·d),0.5g/kg increasing day by day, until the maximum dose to2.5g/(kg·d). These two sets of intestinal atresia on the basis of conventional therapy in the postoperative infusion of glucose, increased day by day from1.5-2g/kg from6-8g/(kg·d), increased to a maximum dose of16-18g/(kg·d), the concentration of10%-12%, the concentration should be less than12.5%and20%in long-chain fat emulsion1.0/(kg·d), after increasing daily1.Og/kg, gradually increased to2.5g/(kg·d). Two sets of daily per kg of body weight of the total amount of liquid glucose, the same amount of intake of fat emulsion. By two groups of amino acids and other nutrient solution mixed with infusion pump control,24h uniform infusion. During hospitalization observed two groups of children with clinical and laboratory science indicators. Important indicators for statistical analysis.Results1. In parenteral nutrition Time (d), the length of stay (d),the test group were10.93±2.02and18.36±2.65; the control group13.25±1.88and21.13±3.50,the test group were less than the control group, the difference was statistically significant (P <0.05).2. Discharge children weighing more growth on admission (g),the test group88.57±26.27,the control group35.69±49.74, the weight gain of the test group than in the control group, the difference was statistically significant (P<0.05).3. The test group children after two weeks of liver and kidney function compared with the control group children, the difference was not statistically significant.4. The two groups showed no incidence of parenteral nutrition associated cholestasis.Conclusions:1. The amount of the test group in postoperative intestinal atresia, the children well tolerated, without significant damage to liver and kidney function and parenteral nutrition associated cholestasis, clinical application is safe.2. Compared with the control group, the amount of amino acids in the test group can shorten the time of parenteral nutrition and reduce hospital stay. Improved weight gam.3. The amount of the test group in postoperative intestinal atresia, serum prealbumin was significantly higher, and significantly improved weight gain in children, to further improve the nutritional status of children. |
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