口服胆乳剂给药时间对早产婴儿临床结果的影响:一项随机对照试验
Elif Ceren Oruc1, Kiymet Celık2, Sema Arayici2
1Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
概括
在早产婴儿中,口服大奶粉 (OCA) 改善了食耐受性,并减少了晚发性败血症 (LOS). 扩展的OCA还增加了在出院时的纯母乳养率.
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:
- 口服胆乳剂 (OCA) 是新生儿的安全干预措施.
- 之前的研究表明,OCA可降低早产婴儿死性肠球炎 (NEC) 和晚发性败血症 (LOS).
- 对OCA的最佳持续时间仍未确定.
研究的目的:
- 评估不同持续时间的OCA对NEC发病率 (阶段≥2) 和早产婴儿其他疾病的影响.
- 为了比较短期 (3天) 和延长 (10天) 的OCA与没有OCA.
主要方法:
- 这是一项随机对照研究,涉及早产婴儿在怀孕32周之前出生.
- 婴儿被分为三个组:没有OCA,短期OCA (3天) 和延长OCA (10天).
- 额外的分析比较了结合的母乳组 (短期和延长) 与非母乳组.
主要成果:
- 在非乳牛奶组中,NEC的发病率为10.9%,在短期组中为4.3%,在扩展组中为0%.
- 虽然在持续时间上没有统计学意义,但OCA组显示NEC率下降 (OR:0.19;95%CI:0.11-0.32).
- 在OCA组中,更早地实现了全肠养,抗生素持续时间更短,LOS率更低 (p=0.004,p<0.001,p=0.004).
- 扩展的OCA组在出院时拥有最高的纯母乳养率 (p=0.003).
结论:
- 口服胆汁可以改善食耐受性,并减少早产婴儿晚发性败血症.
- 延长OCA的使用与出院时更高的纯母乳养率有关.
- 虽然在本研究中没有达到统计学意义,但OCA显示了减少NEC发病率的趋势.
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