摘要
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3mg／（kg·次）、10mg／（k·次）红霉素或等量生理盐水口服或鼻饲，每8小时1次，疗程14d。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）dVS（9．3±1．2）dVS（7．8±1．1）d]及住院时间[（13．0±1．4）dVS（8．1±0．8）dVS（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，不同剂量红霉素组两组相似，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。
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 ）, high- dosage erythromycin group （ HE group ,n = 30） and control group （ n = 30）. Patients received either erythro- mycin （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 E （ 3.0 _＋ 0. 5 ） d, （ 6. 2 e 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） dvs（7.8±1. 1） d] and hospital length of stay [（13.0±1.4） dvs （8.1±0.8） dvs （6.8± 0. 7 ） d ] were significantly prolonged in control group compared with LE and HE groups, and there were sig- nificant 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 high- dosage oral erythromycin is mo
出处
《中国小儿急救医学》
CAS
2012年第4期380-382,共3页
Chinese Pediatric Emergency Medicine
基金
国家自然科学基金（81102227）
关键词
胃肠功能紊乱
红霉素
婴儿
新生
Functional gastrointestinal dysmofility
Erythromycin
Infant, newborn
