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1例药物性早产新生儿胆汁淤积性肝炎的分析
李三妮1,2,龚小慧1,尹雪冬1,胡文娟1,李志玲1
0
(1.上海市儿童医院,上海交通大学医学院附属儿童医院,上海 200062;2.河北省儿童医院,河北石家庄 050031)
摘要:
[摘要] 1例胎龄34+2周天早产儿,生后因早产儿、低出生体质量儿、胸腔积液、乳糜胸给予肠外营养+醋酸奥曲肽注射液治疗。静脉营养和奥曲肽注射液等主要治疗药物停止输注后,即住院治疗41 d时,肝功能检查示显著异常,补充诊断为胆汁淤积性肝炎。在排除了遗传代谢等可能的原因后,判定为药物相关性胆汁淤积,高度怀疑为静脉营养的长时间应用引起。确诊后给予复方甘草酸苷片+熊去氧胆酸胶囊改善肝功能,出院后定期复查。继续内科保肝治疗45 d后,复查肝功能正常,遂停药。
关键词:  奥曲肽  肠外营养  胆汁淤积性肝炎  早产儿
DOI:doi:10.13407/j.cnki.jpp.1672-108X.2022.10.004
基金项目:
A Case of Premature Infant with Cholestasis Induced by Drugs
Li Sanni1,2, Gong Xiaohui1, Yin Xuedong1, Hu Wenjuan1, Li Zhiling1
(1. Shanghai Children’s Hospital, Children’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200062, China; 2. Children’s Hospital of Hebei, Shijiazhuang 050031, China)
Abstract:
[Abstract] A case of premature infant with gestational age of 34+2 weeks was given parenteral nutrition and octreotide acetate injection for the treatment of premature infant, low birth weight infant, pleural effusion and chylothorax. After the main therapeutic drugs such as intravenous nutrition and octreotide injection were discontinued, that is, 41 d after hospitalization, the liver function test showed significant abnormalities, and the supplementary diagnosis of cholestatic hepatitis was made. After excluding possible causes such as genetic metabolism, it was judged to be drug-related cholestasis, which was highly suspected to be induced by the prolonged application of parenteral nutrition. After diagnosis, compound glycyrrhizin tablets and ursodeoxycholic acid capsules were given to improve the liver function, and regular follow-up was performed after discharge. After 45 d of liver protection treatment, the liver function was normal, and the drug was discontinued.
Key words:  octreotide  parenteral nutrition  cholestatic hepatitis  premature infants

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