静脉小剂量红霉素预防早产儿喂养不耐受的Meta分析

Effectiveness of intravenous low-dose erythromycin for feeding intolerance in preterm infants： a meta-analysis

目的系统评价国内静脉小剂量红霉素治疗早产儿喂养不耐受的疗效和安全性。方法采用Cochrane系统综述，计算机检索中国期刊全文数据库、重庆维普中文科技期刊数据库及万方数据库，查找相关应用小剂量红霉素治疗早产儿喂养不耐受的随机对照试验，并手工检索相关杂志、专业资料和网络信息，追索纳入文献的参考文献，检索时限为建库至2012年8月。采用Cochrane协作网提供的RevMan4．2软件进行分析。结果最终共检索符合纳入标准的9篇随机对照试验文献。与单用综合治疗组相比，小剂量红霉素组住院时间、静脉营养时间、足量喂养时间、喂养不耐受发生率方面明显优于综合治疗组（Z=3．44，P=0．0006；Z=6．78，P〈0．00001；Z=3．96，P〈0．0001；Z=2．51，P=0．01），差异均有统计学意义（P〈0．05）。结论用小剂量红霉素预防早产儿喂养不耐受明显优于综合治疗组，具有很好的应用前景，但可靠的结论仍需要大样本、多中心、设计良好的随机对照试验的进一步验证。

Objective To evaluate the effectiveness of low-dose erythromycin for the treatment of feeding intolerance in preterm infants in China. Methods In this study, random clinical trials on the treat- ment of feeding intolerance in preterm infants with intravenous low-dose erythromycin published were searched at Chinese Journal Full-text Database, Chongqing Weipu Database and Wanfang database by using the methods of Cochrane systematic review. At the same time the information from related journals, profes- sional data and network were hand-searched. The publishing deadline for the literatures reviewed in this study was August 2012. Statistical analysis of clinical data was performed by using RevMan 4. 2 software provided by the Cochrane Collaboration. Results A total of 9 studies were included. The results showed that com- pared with the group of comprehensive therapy, the group of low-dose erythromycin was superior in the fol- lowing aspects with significant differences （ P 〈 0. 05 ） ： the average length of hospital stay, time of parenteral nutrition, time to full feeding, the incidence rate of feeding intolerance （ Z = 3.44, P = 0. 000 6 ; Z = 6. 78, P 〈 0. 00001;Z=3.96,P〈0. 0001;Z= 2. 51,P =0. 01）.Conclusion Low-dose erythromycin therapy for feed- ing intolerance in preterm infants is superior to the comprehensive therapy. It provides a prospective therapeu- tic method for feeding intolerance in preterm infants. However, large scale, multicenter and well-designed clinical trials should be adopted to confirm the conclusions.