小剂量红霉素对不同校正胎龄早产儿早期喂养的疗效对比

Comparison of efficacy of low-dose intravenous erythromycin on early feeding in preterm infants with different corrected gestational age

目的探讨静脉应用小剂量红霉素后不同校正胎龄早产儿早期喂养出现的疗效差别。方法选择2011-2013年间校正胎龄〉32周及≤32周时开始经口喂养早产儿各30例，分别随机分成大胎龄红霉素组（n=15）、大胎龄对照组（n=15）和小胎龄红霉素组（n=15）、小胎龄对照组（n=15），两个红霉素治疗组在常规治疗的基础上采用小剂量红霉素3—5mg／kg静滴，1次／d，疗程7d。两个对照组均采用常规治疗。测量并比较各组早产儿相关营养和生长发育指标。结果大胎龄红霉素组与大胎龄对照组相比较，其恢复出生体质量时间、全胃肠道营养时间及体质量平均增长速度差异有统计学意义（P〈0．05），但小胎龄红霉素组与小胎龄对照组比较差异无统计学意义（P〉0．05）。结论红霉素能有效改善校正胎龄〉32周开始经口喂养的早产儿营养状况，促进其早期体格发育，但对≤32周开始经口喂养的早产儿无效。

Objective To explore the efficacy of low-dose intravenous erythromycin in the treatment of early feeding in preterm infants at different corrected gestational age. Methods From 2011 to 2013, thirty preterm infants at the corrected gestational age less than or equal to 32 weeks were randomly divided into two groups： small gestational age erythromycin group （group SE） and small gestational age control group（ group SC） ;another thirty preterm infants at the corrected gesta- tional age over 32 weeks were also randomly divided into two groups：big gestational age erythromycin group（ group BE） and big gestational age control group（ group BC）. Group SE and group BE were given erythromycin [ 3 to 5mg/（ kg · d） for 7 days ] by intravenous drip, while the control groups received conventional treatment. Nutrition, growth and development indicators were measured and compared among these groups. Results Compared with group BC, the time to return birth weight, the time to all enteral nutrition, the rate of growth in body weight were significantly different from those in group BE （ P 〈 0.05 ）, but there were no obvious differences between group SC and group SE （ P 〉 0. 05 ）. Conclusion Erythromycin can effectively improve the nutrition status and promote early growth and development in preterm infants at the corrected gestational ages of less than or equal to 32 weeks. But there is no significant curative effect to the preterm infants at the corrected gestational ages over 32 weeks.