早期肠道内营养对极低出生体重早产儿临床结局影响的Meta分析

Meta-analysis of the Impact of Early Enteral Nutrition on the Clinical Outcomes of Very Low Birth Weight Premature Infants

目的系统评价早期肠道内营养对极低出生体重早产儿临床结局的影响。方法通过计算机检索有关极低出生体重早产儿应用早期肠道内营养后临床结局指标相关的文献,检索时间为建库起至2023年12月31日;数据提取后用RevMan5.4软件进行Meta分析。结果共筛选出323篇文献,最终纳入8篇,总样本量为3451例,Meta分析的结果显示,早期肠道内营养对极低出生体重早产儿住院时长[MD=-17.26,95%CI(-35.41,0.89),P=0.06]、NEC发病率[RR=0.98,95%CI(0.75,1.27),P=0.85]等无影响;但早期肠道内营养可以减少极低出生体重早产儿达全肠道内喂养时间[MD=-3.44,95%CI(-4.15,-2.73),P<0.00001]、静脉营养时间[MD=-5.90,95%CI(-10.42,-1.38),P=0.01]、喂养不耐受发生率[RR=0.70,95%CI(0.63,0.77),P<0.00001],感染发生率[RR=0.57,95%CI(0.42,0.76),P=0.0001]。结论早期肠道内营养能减少极低出生体重早产儿达全肠道营养时间、静脉营养时间、喂养不耐受发生率、感染发生率。

Objective To evaluate the effect of early enteral nutrition on the clinical outcomes of very low birth weight preterm infants.Methods The literature on the use of early enteral nutrition and clinical outcome measures in VLBW premature infants was searched by computer until 31 December 2023.The data were extracted for Meta-analysis with RevMan5.4 software.Results A total of 323 articles were selected,and 8 articles were selected,with a total sample size of 3451 cases,the results of the Meta-analysis showed that early enteral nutrition for hospitalization of very low birth weight preterm infants[MD=-17.26,95%CI(-35.41,0.89),P=0.06],incidence of NEC[RR=0.98,95%CI(0.75,1.27),P=0.85]has no effect.But early enteral nutrition can reduce the duration of full enteral feeding in very low birth weight premature infants[MD=-3.44,95%CI(-4.15,-2.73),P<0.00001],reducing the time of parenteral nutrition[MD=-5.90,95%CI(-10.42,-1.38),P=0.01],incidence of feeding intolerance[RR=0.70,95%CI(0.63,0.77),P<0.00001],Reduced incidence of infection[RR=0.57,95%CI(0.42,0.76),P=0.0001].Conclusion Early enteral nutrition can reduce the total duration of enteral nutrition,parenteral nutrition,incidence of feeding intolerance and infection.