从第1天开始,完全使用肠道液体,与早产婴儿逐步养 (FEED1) 相比:一个开放式,并行组,多中心,随机,优越性试验
Shalini Ojha1, Eleanor J Mitchell1, Mark J Johnson2
1School of Medicine, University of Nottingham, Nottingham, UK.
The Lancet. Child & adolescent health
|October 20, 2025
概括
在早产婴儿 (怀孕30-32周) 的第1天开始全乳养并没有缩短住院时间. 这种养策略也没有增加死性肠球炎或低血糖症的风险.
科学领域:
- 新生儿医学 新生儿医学
- 儿科胃肠病学 儿科胃肠病学
- 临床营养学 临床营养学
背景情况:
- 过早出生的婴儿通常与静脉注射液体或亲肠营养一起获得逐渐的牛奶养.
- 早期母乳养可能会减少住院和感染风险,但可能会增加死性肠球炎风险.
研究的目的:
- 调查从第1天开始,与逐渐的母乳养相比,仅使用肠道液体 (全乳养) 是否会减少早产婴儿 (30-32周妊娠) 的住院时间.
主要方法:
- 一个开放的,多中心的,随机优越性试验,涉及2088名婴儿,出生在妊娠30周到32周之间.
- 婴儿在出生后3小时内被随机分配到完全牛奶养 (60-80毫升/公斤/天) 或逐步牛奶养 (在第一天最大30毫升/公斤/天) 随着IV支持.
- 主要结局是住院时间长度;安全结局包括死性肠球炎和低血糖症. 进行了治疗意向分析.
主要成果:
- 在全乳养组 (32.4天) 和逐渐养组 (32.1天) 之间的住院时间没有显著差异.
- 在两组中都观察到相似的存活率到出院,死性肠球炎和低血糖事件.
- 严重的不良事件是罕见的,在两组之间是相似的,没有报告与试验干预的关系.
结论:
- 在早产婴儿 (妊娠30-32周) 中,从第1天开始开始全母乳养不会改变住院时间.
- 这种早期养策略不会增加死性肠球炎或低血糖症的风险.
- 对于这个早产婴儿群体,目前的食指南可以保持,而不会增加不良结果.
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