目的探讨不同剂量维生素D3预防早产儿维生素D缺乏性佝偻病的应用效果及护理对策。方法对2014年1月-2016年1月于深圳坪山新区人民医院接受治疗的早产儿85例为研究对象,按照维生素D3使用剂量的不同分为低剂量组(400 IU/天)和高剂量组(800 IU/天)。对比分析两组早产儿治疗后维生素D缺乏性佝偻病的发生率,治疗前后相关生化指标和有效追赶成长率的变化及治疗不良反应发生情况。结果高剂量组早产儿佝偻病发生率为5.55%,低剂量组为18.18%,两组相比差异有统计学意义(P<0.05);高剂量组治疗后血钙含量(3.86±1.04 mmol/L),有效追赶成长率(94.44%)、25(OH)D含量(63.5±4.24ng/L),骨钙素(19.32±1.23μg/l)及骨源性碱性磷酸酶含量(291.4±56.3U/L)均明显高于低剂量组治疗后相应指标,差异有统计学意义(P<0.05);而两组早产儿治疗并发症发生率差异无统计学意义(P>0.05)。结论高剂量维生素D制剂配合相应护理对策,更有利于减少早产儿维生素D缺乏性佝偻病的发生,且不增加并发症发生率,在临床上值得推广应用。

Objective To explore the clinical effect of different dose of vitamin D on preventing premature rickets and its' nursing strategy. Methods From Jan 2014 to Jan 2016,85 premature infants who accepted cured in Pingshan District People's Hospital were selected as the study objects,and they were divided into low dose group(400 IU/d) and high dose group(800 IU/d) according to the dose of vitamin D. The incidence of rickets,related biochemical indexes before and after treating,the changes of the effective catch-up growth rate and adverse reaction between the two groups were compared. Results The incidence of rickets in high dose group was 5.6%,while the low group was 18. 2%,and the difference was statistically significant(P < 0. 05); In high dose group,the content of Calcium(3. 86 ± 1. 04mmol/L),effective catch-up growth rate(94. 44%),25(OH) D(63. 5 ± 4. 24 ng/L),bone Calcium(19. 32 ±1. 23μg/L) and bone alkaline phosphatase(291. 4 ± 56. 3 U/L) were all higher than those in low dose group(P < 0. 05); while there was no statistical difference between the two groups in adverse reactions(P > 0. 05). Conclusion High dose vitamin D with relevant nursing strategy is more conducive to decrease the rate of premature rickets and without increasing the incidence of adverse reactions,it is worthy of clinical application.