益生菌用于预防非常早产或出生体重非常低的婴儿死亡性肠球炎
Sahar Sharif1, Sam J Oddie2, Paul T Heath3
1Centre for Reviews and Dissemination, University of York, York, UK.
The Cochrane database of systematic reviews
|June 1, 2023
概括
益生菌补充剂显示,低确定性证据表明,它可以降低死结肠炎 (NEC) 和非常早产婴儿的死亡率. 需要更多高质量的试验来证实这些发现并指导临床实践.
科学领域:
- 新生儿医学 新生儿医学
- 微生物组研究 微生物组研究
- 临床营养学 临床营养学
背景情况:
- 死性肠球炎 (NEC) 对非常早产或出生体重非常低 (VLBW) 的婴儿构成重大风险.
- 调节肠道微生物群与 prebiot oligosaccharides 是一个建议的策略,以减轻NEC和相关的并发症.
研究的目的:
- 评估肠道益生菌补充剂在预防NEC及其相关VLBW婴儿的发病率和死亡率方面的疗效和安全性.
- 评估益生菌对侵袭性感染和神经发育结果的影响.
主要方法:
- 随机对照试验 (RCT) 和准RCT的系统审查和元分析.
- 在多个数据库中搜索到2022年7月的试验,比较益生菌与安慰剂或没有治疗的VLBW婴儿.
- 提取了关于NEC,死亡率,感染,住院时间和神经发育的数据;使用GRADE评估了偏差风险和证据确定性.
主要成果:
- 包括7项涉及705名婴儿的小型试验;在一些试验中发现了潜在的偏差.
- 分析表明,在NEC,全因死亡率或晚发入侵性感染 (低确定性证据) 中几乎没有差异.
- 非常低的确定性证据表明神经发育障碍的潜在益处,但研究结果不准确.
结论:
- 目前关于在VLBW婴儿中使用益生菌预防NEC的证据确定性低至非常低.
- 对效果估计的信心有限,需要进行大规模,高质量的试验.
- 进一步的研究对于基于证据的临床实践和政策决策至关重要.
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