小剂量红霉素防治极低出生体重儿喂养不耐受的临床研究

目的:探讨小剂量红霉素防治极低出生体重儿喂养不耐受的疗效及安全性。方法:入选111例极低出生体重儿,按住院号单双方法划分,治疗组(单号)58例,对照组(双号)53例,两组均于出生48h给予经口间断管饲,治疗组同时静脉滴注小剂量红霉素,观察对比两组以下指标:早期胃肠喂养耐受情况、停止管饲日龄、达全胃肠营养日龄、黄疸持续时间、谷丙转氨酶及谷氨酰转肽酶高值。结果:死亡率:治疗组13.8%,对照组13.2%(P=0.937 3);喂养不耐受发病率:治疗组12%,对照组78.3%(P<0.000 1);治疗组停止管饲日龄、全胃肠营养日龄、黄疸持续时间、谷丙转氨酶(ALT)及谷氨酰转肽酶(γ-GT)最高值明显小于对照组(P<0.01),日大便数较对照组多(P=0.010 3)。结论:小剂量红霉素防治极低出生体重儿喂养不耐受是安全有效的。

Clinical Research of Low-dose Erythromycin in the Prophylaxis and Treatment of Feeding Intolerance in Very Low Birth Weight Infants

Objective:To explore the efficiency and security of low-dose erythromycin in the prophylaxis and treatment of feeding intolerance in very low birth weight infants.Methods:111 cases of very low birth weight infants were assigned to either treatment group(odd numbers,58 cases) or control group(even numbers,53 cases) according to their admission number.Infants of two groups were both executed oral intermittent tube feeding in 48 hours after birth.In treatment group,the patients were given low-dose erythromycin intravenously at the same time.The following indexes of two groups were observed and compared:early gastrointestinal feeding tolerance,the days of stopping tube feeding,the days of reaching total gastrointestinal nutrition,duration of jaundice,the high values of alanine aminotransferase and glutamyl transpeptidase.Results:Mortality of treatment group and control group is 13.8% and 13.2%(P=0.937 3).Feeding intolerance incidence is respectively 12%,78.3% in treatment group and control group(P<0.000 1).The days of stopping tube feeding,the days of reaching total gastrointestinal nutrition,duration of jaundice,the high values of alanine aminotransferase(ALT) and glutamyl transpeptidase(γ-GT) in treatment group were significantly lower than that of control group(P<0.01).Daily stool frequency in treatment group was more than control group(P=0.010 3).Conclusion:The method of low-dose erythromycin in the prophylaxis and treatment of feeding intolerance in very low birth weight infants is safe and effective.