口服红霉素在极低出生体重早产儿喂养不耐受的治疗作用

【目的】 评价口服不同剂量红霉素对早产儿喂养不耐受(feeding intolerance,FI)的治疗效果及可能存在的副作用,尤其对极低出生体重早产儿FI的治疗作用。 【方法】 选取2008年1月1日-2010年3月31日在16家三甲医院新生儿科住院并诊断为FI的早产儿,随机分为3组:红霉素大剂量组(第8~10日龄起口服红霉素 12.5 mg/kg,q8 h,疗程7~10 d)、红霉素小剂量组(口服红霉素5 mg/kg,给药方法同上)、对照组(完全不用胃肠动力调节药物)。比较各项喂养相关指标、宫外生长迟缓发生率等,并评估药物副作用。 【结果】 入组极低体重儿46例,大剂量组11例,小剂量组22例,对照组13例。两治疗组肠内热卡达基础热卡的日龄及体重开始增长时肠内热卡比例较对照组明显改善,大剂量组体重宫外生长迟缓发生率较对照组明显降低。所有治疗组患儿随访6个月均未见明显红霉素副作用。 【结论】 本研究中选取的两种剂量红霉素口服对极低出生体重早产儿FI均有一定治疗作用,大剂量略优于小剂量。所采用的红霉素治疗方案未见明显副作用。

Oral erythromycin for treatment of feeding intolerance in very low birth weight preterm infants

【Objective】 A prospective,multi-center,controlled study was performed to evaluate the effectiveness and possible side effects of oral erythromycin (EM) in treating preterm infants,especially VLBW(very low birth-weight )preterm infants with feeding intolerance(FI). 【Methods】 46 preterm infants with FI from 16 hospitals were enrolled,study period from January,2008 to March,2010.The patients were divided into 3 random groups:EM-HD group,oral erythromycin 12.5 mg/kg,q8h for 7~10 days; EM-LD group,oral erythromycin 5 mg/kg,therapy as above; and control group,not treated by any gastrointestinal prokinetic agent.Several critical time points of feeding condition were compared,the incidence of extrauterine growth retardation (EUGR) and the potential adverse effects of erythromycin were also evaluated. 【Results】 11 patients had be classed as EM-HD group,22 as EM-LD group,13 as control.After enrollment,the time reaching 50 kCal/(kg·d) from enteral feeding were significantly shorter and the proportions of calorie ingested by the enteral route when the infants regained to their birth weight were significantly higher in two trial groups than the control group.The incidence of EUGR was significantly lower in EM-HD group.All enrolled infants were followed up from discharge to 6 months' age,no obvious side effect was found in the trial groups. 【Conclusions】 In this research,both doses of oral erythromycin are effective for treating VLBW preterm infants with FI and the high dose is more effective.There are not obvious side effects of oral erythromycin observed.