早期微量喂养对我国低出生体重儿的效果评价——meta分析

A meta-analysis on the effect of early minimal feeding on low birth weight infants of China

目的:为评价早期微量喂养对我国低出生体重儿的相关影响。方法:主题词交叉联合检索中国生物医学文献、中国学术期刊全文、万方、维普数据库。获得建库以来至2014年相关文献,检索MEDLINE以发现国内研究者在非中文期刊上发表的非重复报告。结果:共纳入24个临床试验,1早期微量喂养组达全胃肠时间短于对照组(WMD=-5.73;95%CI:-6.68^-4.78;P<0.01);2早期微量喂养组每日体重增长高于对照组(WMD=3.64;95%CI:1.85~5.44;P<0.001);3早期微量喂养组恢复至出生体重时间短于对照组(WMD=-2.59;95%CI:-3.35^-1.83;P<0.001);4早期微量喂养组新生儿坏死小肠结肠炎(NEC)发生率与对照组无明显差异(OR=0.70;95%CI:0.35~1.41;P=0.32);5早期微量喂养组喂养不耐受发生率明显低于对照组(OR=0.38;95%CI:0.24~0.60;P<0.001);6早期微量喂养组低血糖发生率低于对照组(OR=0.19;95%CI:0.10,0.35;P<0.001)。结论:早期微量喂养患儿在达足量肠内营养时间、恢复至出生体重时间、体重增长等方面优于静脉营养组;同时可减少低血糖、NEC、喂养不耐受等并发症的发生。

Objective：To evaluate the effect of early minimal feeding on low birth weight infants of China. Methods：We searched CBM,CAJ,Wanfang and CQVIP databases using keywords since databses established. Also we searched MEDLINE for Chinese papers. Results：Tweenty-four researches were included.（1）Time of parenteral nutrition in early minimal feeding group is shorter than control group WMD=-5.73;95% CI =[-6.68,-4.78];P〈0.00001;（2）Weight gain per day in early minimal feeding group is more than control group WMD= 3.64;95%CI=[1.85,5.44];P〈0.0001;（3）Time of returning to birth weight in early minimal feeding group is shorter control group WMD =-2.59;95% CI =[-3.35,-1.83];P〈0.00001;（4）Incidence of NEC in early minimal feeding group doesn＇t show statistical significance compared with control group OR = 0.70;95% CI =[0.35,1.41];P =0.32;（5）Incidence of feeding intolerance is lower than control group OR = 0.38;95% CI =[0.24,0.60];P〈0.0001;（6）Incidence of hypoglycemia is lower than control group OR = 0.19;95% CI =[0.10,0.35];P〈0.00001. Conclusion：The early minimal feeding group has an advantage over control group in time of parenteral nutrition,weight gain,time of returning to birth weight,incidence of NEC,feeding intolerance and hypoglycemia.