摘要
目的研究异基因造血干细胞移植(allo-HSCT)患儿接受肠外营养(PN)治疗期间的并发症发生情况,并确定可能的危险因素。方法收集2019年6月—2022年5月于我院行allo-HSCT患儿的临床资料,使用因果关系评估法,从患儿医疗记录中收集与PN相关的并发症。采用多元回归模型对并发症的独立危险因素进行分析。结果研究时间内共223例患儿行allo-HSCT,其中PN治疗者92例(42%)。共有85%(n=78)的患儿发生了213例次可归因于PN的并发症。平均每位患儿发生(2.31±1.66)例次(最少=1,最多=8),每100个PN日可能发生5.5例次并发症。并发症主要为电解质紊乱(n=89)、糖脂代谢紊乱(n=45)、肝功能损害(n=35)、胆汁淤积(n=21)、尿素氮(BUN)升高(n=11)和感染(n=12)。多因素变量分析显示,PN持续时间(P=0.004)和血糖异常(P=0.007)是出现并发症的危险因素。结论allo-HSCT期间PN可引起较多并发症,且随PN时间延长而增多。虽然很难明确并发症与PN之间的绝对相关性,肠内营养可能是减少各种并发症的最佳方法。
Objective To investigate parenteral nutrition(PN)-related complications in children after allogenic hematopoietic stem cell transplantation(allo-HSCT)and determine the possible risk factors.Methods Clinical data of patient received allo-HSCT in our hospital from June 2019 to May 2022 were collected,causality method was used to collect PN-related complications.Multivariate regression model was used to analyze independent risk factors for PN-related complications.Results A total of 219 children underwent allo-HSCT during the study period,of which 92(42%)were treated with PN.We identified 213 complications attributable to PN in 78 patients(85%)with a mean of 2.31±1.66 complications per patient(min=1,ma=8).The incidence rate of complications was 5.5 complications for 100 patient days of PN.The main complications were electrolytic disorders(n=89),glucose and lipid metabolic disorders(n=45),liver function impairment(n=35),cholestasis(n=21),elevated BUN(n=11)and infectious complications(n=12).Multivariate analysis showed that the duration of PN exposure(P=0.004)and abnormal blood glucose(P=0.007)were the risk factors for the onset of these complications.Conclusions PN during allo-HSCT can cause many complications.And the complications increased with the extension of PN exposure.A certain causal link is difficult to establish in this particular context.Emphasizing enteral nutrition in HSCT would be the best way to reduce various complications.
作者
杨文利
秦茂权
贾晨光
王彬
朱光华
杨骏
骆燕辉
郑杰
闫洁
YANG Wenli;QIN Maoquan;JIA Chenguang;WANG Bin;ZHU Guanghua;YANG Jun;LUO Yanhui;ZHENG Jie;YAN Jie(Department of Clinic Nutrition,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China;Department of Hematopoietic Stem Cell Transplantation,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China)
出处
《中国小儿血液与肿瘤杂志》
2025年第1期30-34,共5页
Journal of China Pediatric Blood and Cancer
作者简介
通讯作者:闫洁,Email:yanjie804@sina.com。
