小剂量红霉素预防早产儿喂养不耐受的临床研究

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 选择早产儿胎龄30～31周52例和胎龄32～34周68例,分别在两个胎龄内各按随机分配的原则均分为用药组和对照组,其中用药组于生后第2天常规给予红霉素3 mg/(kg·d),1次/d,共10 d;对照组给予5%葡萄糖注射液3 ml/(kg·d).结果 在胎龄30～31周早产儿用药组和对照组达全肠内喂养时间、恢复出生体重时间、住院时间、喂养不耐受发生率比较差异均无统计学意义(P>0.05).而在胎龄32～34周早产儿用药组与对照组达全肠内喂养时间分别为(13.8±4.5)、(17.2±4.2)d]、恢复出生体重时间分别为(10.5±1.6)、(13.8±1.5)d]、住院时间分别为(28.5±6.8)、(35.5±7.2)d]及喂养不耐受发生率分别为17.6%(6/34)、35.3%(12/34)]差异均有统计学意义(P<0.05).结论 小剂量红霉素预防早产儿喂养不耐受.对胎龄32～34周的早产儿是安全有效的,但对胎龄30～31周的早产儿效果却不显著.

Clinical study of low-dose erythromycin for the prevention of feeding intolerance in preterm infants

Objective To evaluate the efficacy and safety of low-dose erythromycin for the prevention of feeding intolerance in preterm infants. Methods Fifty-two preterm infants (30-31 weeks' GA group) and 68 preterm infants (32-34 weeks' GA group) were randomly subdivided into prevention groups and control groups. From the second day the prevention groups received intravenously erythromycin 3 mg /(kg·d)] for 10 days,the control groups received placebo of glucose. Results In 30-31 weeks' GA group,days to achieve full enteral feeding (DAFEF) ,days to regain birth weight (DRBW) and duration of hospitalization (DH) were shorter in the prevention group as compared to those in the control group, the incidence of feeding intolerance was lower too,but there was no significant difference (P >0.05). In 32-34 weeks' GA group, DAFEF (13.8±4.5) d],DRBW (10.5±1.6) d],DH (28.5±6.8) d] were significantly shorter in the prevention group than those in the control group (17.2±4.2), (13.8±1.5), (35.5±7.2) d],the incidence of feeding intolerance in the prevention group was lower too 17.6%(6/34) vs 35.3%( 12/34) ], there was significant difference (P < 0.05 ). Conclusion In 32-34 weeks' GA, low-dose erythromycin can be a safe and effective method to promote food tolerance in preterm infants, but not sure in 30-31 weeks' GA.