CAJ | 학술논문

目的评估口服红霉素对新生儿胃肠道功能紊乱的疗效.方法采用随机、双盲、安慰剂对照试验,选择2009年1月至2011年12月于深圳市儿童医院新生儿重症监护室住院的90例患儿作为研究对象,随机分为小剂量红霉素组、大剂量红霉素组和对照组,每组30例,分别给予3 mg/(kg·次)、10 mg/(kg·次)红霉素或等量生理盐水口服或鼻饲,每8小时1次,疗程14 d.比较各组患儿达到半量、3/4量及全量肠内营养时间、肠外营养时间及住院时间.结果与对照组[(8.1±0.4)d,(13.5±1.0)d,(15.7±1.2)d]比较,大剂量红霉素组[(3.0±0.5)d,(6.2±0.7)d,(8.2±1.0)d]和小剂量红霉素组[(6.2±0.5)d,(8.3±0.6)d,(10.6±1.1)d]患儿达到半量、3/4量及全量肠内营养的时间均明显提前(P＜0.05).肠外营养时间[(14.2±1.4)d vs (9.3±1.2)d vs (7.8±1.1)d]及住院时间[(13.0±1.4)d vs (8.1 ±0.8)d vs (6.8±0.7)d],对照组明显长于不同剂量红霉素组,3组间比较差异均有统计学意义(P＜0.05).治疗期间发生肝功能损害、脓毒症的患儿,不同剂最红霉素组两组相似,但是比对照组明显降低.未见口服红霉素治疗的相关不良反应(QT间期延长、心律失常).结论口服红霉素可以作为肠内营养不足的新生儿胃肠道功能紊乱的治疗方法,并且口服大剂量红霉素较小剂量效果更好.
목적 평고구복홍매소대신생인위장도공능문란적료효.방법 채용수궤、쌍맹、안위제대조시험,선택2009년1월지2011년12월우심수시인동의원신생인중증감호실주원적90례환인작위연구대상,수궤분위소제량홍매소조、대제량홍매소조화대조조,매조30례,분별급여3 mg/(kg·차)、10 mg/(kg·차)홍매소혹등량생리염수구복혹비사,매8소시1차,료정14 d.비교각조환인체도반량、3/4량급전량장내영양시간、장외영양시간급주원시간.결과 여대조조[(8.1±0.4)d,(13.5±1.0)d,(15.7±1.2)d]비교,대제량홍매소조[(3.0±0.5)d,(6.2±0.7)d,(8.2±1.0)d]화소제량홍매소조[(6.2±0.5)d,(8.3±0.6)d,(10.6±1.1)d]환인체도반량、3/4량급전량장내영양적시간균명현제전(P＜0.05).장외영양시간[(14.2±1.4)d vs (9.3±1.2)d vs (7.8±1.1)d]급주원시간[(13.0±1.4)d vs (8.1 ±0.8)d vs (6.8±0.7)d],대조조명현장우불동제량홍매소조,3조간비교차이균유통계학의의(P＜0.05).치료기간발생간공능손해、농독증적환인,불동제최홍매소조량조상사,단시비대조조명현강저.미견구복홍매소치료적상관불량반응(QT간기연장、심률실상).결론 구복홍매소가이작위장내영양불족적신생인위장도공능문란적치료방법,병차구복대제량홍매소교소제량효과경호.
Objective To assess the efficacy of oral erythromycin on the functional gastrointestinal dysmotility in neonates.Methods In this double-blind,randomized,placebo controlled trial,90 neonates consecutively admitted to the neonatal intensive care unit of Shenzhen Children's Hospital from Jan 2009 to Dec 2011 were enrolled and randomly divided into low-dosage erythromycin group ( LE group,n =30 ),highdosage erythromycin group ( HE group,n =30 ) and control group ( n =30).Patients received either erythromycin ( 3 mg/kg or 10 mg/kg) or equivalent normal saline with oral or nasal feeding every 8 hours one time for 14 d.The time to achieve half,three-quarters,and full enteral nutrition,the time of parenteral nutrition,and hospital length of stay were compared among each group.Results The time to achieve half,three-quarters,and full enteral nutrition in HE group [ ( 3.0 ± 0.5 ) d,( 6.2 ± 0.7 ) d,( 8.2 ± 1.0 ) d ] and in LE group [(6.2±0.5) d,(8.3 ±0.6) d,(10.6 ±1.1) d] were shorter than that in control group [(8.1 ±0.4) d,( 13.5 ± 1.0) d,( 15.7 ± 1.2) d] ( P ＜ 0.05 ).The duration of parenteral nutrition [ ( 14.2 ± 1.4) d vs (9.3 ± 1.2) d vs (7.8 ± 1.1 ) d ] and hospital length of stay [ ( 13.0 ± 1.4 ) d vs ( 8.1 ± 0.8 ) d vs ( 6.8 ±0.7) d] were significantly prolonged in control group compared with LE and HE groups,and there were significant differences among the three groups ( P ＜ 0.05).The incidence of liver injury and septicemia during the treatment of erythromycin were similar between HE group and LE group,but it was significantly lower than control group.No serious adverse effect such as prolongation of QT intervals,dysrhythmia associated with erythromycin treatment was found.Conclusion Oral erythromycin can be considered as a treatment for neonates with functional gastrointestinal dysmotility who fail to establish adequate enteral nutrition,and highdosage oral erythromycin is more effective than low-dosage.