Çok düşük doğum ağırlıklı bebeklerde total parenteral beslenme ilişkili kolestaz ve ursodeoksikolik asit tedavisinin etkinliği

Year 2006, Volume: 13 Issue: 4, 7 - 11, 29.04.2009

Hasan Çetin Sevgi Kosacı Akdeniz Şeref Olgar Faruk Öktem Bumin Dündar Ali Ayata

Abstract

SüleymanDemirel Üniversitesi
TIP FAKÜLTESİ DERGİSİ: 2006 Aralık; 13(4)


Çok düşük doğum ağırlıklı bebeklerde total parenteral beslenme ilişkili kolestaz ve ursodeoksikolik asit tedavisinin etkinliği


Hasan Çetin, Sevgi Kosacı Akdeniz, Şeref Olgar,
Faruk Öktem, Bumin Dündar, Ali Ayata








Özet







Çok düşük doğum ağırlıklı bebeklerde uzun süreli parenteral beslenme gereklidir ve kolestaz riski de fazladır. Çalışmanın amacı çok düşük doğum ağırlığı olan bebeklerde kolestaz oranını, enteral beslenmeyle olan ilişkisini belirlemek, ursodeoksikolik asid tedavisinin etkisini değerlendirmektir. Yenidoğan Yoğun Bakım Ünitesinde çok düşük doğum ağırlıklı bebeklere ait beş yıllık veriler değerlendirildi. Çalışmanın ikinci yarısında gastrointestinal sistem beslenmeye elverişli hale gelince 15-20 ml/kg/gün olacak şekilde minimal enteral beslenme başlandı. Ikinci dönemde total parenteral beslenme süresi uzun olmasına rağmen minimal enteral beslemeye başlama zamanı anlamlı olarak kısa idi(p<0.05). Total kolestaz oranı %12 saptandı. Kolestaz oranının ikinci dönemde belirgin olarak %20.8.den %5.e gerilediği gözlendi(p<0.05). Ursodeoksikolik asid tedavisiyle kolestaz süresinin belirgin oranda kısaldığı gözlendi. Sonuç olarak enteral beslenme olabildiğince çabuk başlanmalıdır. total parenteral beslenme ilişkili kolestaz tedavisinde ursodeoksikolik asid kullanımı faydalı olabilir.







Anahtar kelımeler: Kolestaz, total parenteral beslenme, enteral beslenme, çok düşük doğum ağırlıklı bebek.











Abstract







Total parenteral nutrition-associated cholestasis and the effect of ursodeoxycholic acid in very low birth weight infants







Prolonged parenteral nutrition are necessary and there is high risk of cholestasis in very low birth weight infants. The aim of this study was to determine the rate of cholestasis, correlation with enteral feeding and the effect of ursodeoxycholic acid in very low birth weight infants. The data of five years in Neonatal Intensive Care Unit belong to very low birth weight infants was analysed. In the second half of the performed study, minimal enteral feeding was started by the dose of 15-20 ml/kg/day when the gastointestinal system was ready to feeding. Although total parenteral nutrition days was longer, the age of minimal enteral feeding significantly shorter in second period than first period(p<0.05). Total cholestasis rate was detected as 12%. The rate of cholestasis significantly reduced from 20.8% to 5% in second period(p<0.05). Ursodeoxycholic acid treatment shortened the period of cholestasis significantly. In conclusion enteral feeding should be begin quickly. The use of ursodeoxycholic acid treatment could be beneficial in the treatment of total parenteral nutrition associated cholestasis.







Key words: Cholestasis, total parenteral nutrition, very low birth weight infants, enteral feeding

Keywords

Kolestaz, total parenteral beslenme, enteral beslenme, çok düþük doðum aðýrlýklý bebek

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