小剂量红霉素预防早产儿喂养不耐受的随机对照研究

目的:探讨小剂量红霉素预防早产儿喂养不耐受的疗效及安全性。方法:63例胎龄≤34周,出生体重≤1800g,并除外消化道先天畸形的早产儿被随机分配到对照组和预防用药组(用药组),其中用药组于生后第3d常规给予红霉素10mg/(kg·d),1次/8h,共7d。结果:用药组的喂养不耐受率(26·67%)低于对照组(45·5%),但差异无统计学意义(χ2=2·393,P>0·05)。两组达到完全经肠道喂养的时间、黄疸持续时间和每天大便次数均有明显差异(P<0·05或P<0·01),而平均住院时间的差异则无显著性意义。两组均无心律失常的发生。用药组未出现药物相关性肝功能损害。结论:小剂量红霉素预防早产儿喂养不耐受是安全有效的,但这些结果有待多中心大样本研究的证实。

Randomised controlled study of low -dose erythromycin for the prophylaxis of feed intolerance in preterm infants

Objective:To evalute the efficacy and safety of low-dose erythromycin for the prophylaxis of feed intolerance in preterm.Methods:Sixty three preterm infants without gastrointestinal tract deformities whose gestational age ≤ 34 w (BW≤1 800 g) were randomized to erythromycin group (10 mg/kg per day 8 hourly ) and control group.Results:The incidence of feed intolerance in erythromycin group was lower than that in control group, but not statistically significancy.The times taken to full enteral feeding and jaundice lasted were shorter in erythromycin group as compared to those in the control group (26.8±5.9 d vs 30.6±6.8 d, 20.8±4.2 d vs 25.5~4.9 d, respectively,P<0.05 ).None of the infants developed adverse effects such as vomiting, cardiac dysrhythmias or liver damage.Conclusion:Low-dose erythromycin can be an safe and effective method to promote food tolerance in preterm infants, but further larger muticenter trials should be done.