Objective:To study the effects of prolonging small feeding volumes early in life on the incidence of necrotizing enterocolitis(NEC)in very low birth weight(VLBW)preterm infants.Methods:A total of 128 VLBW infants who ...Objective:To study the effects of prolonging small feeding volumes early in life on the incidence of necrotizing enterocolitis(NEC)in very low birth weight(VLBW)preterm infants.Methods:A total of 128 VLBW infants who could not be breastfed were assigned into the experimental group(63 cases)and the control group(65 cases)using a random number table.The experiment group was fed 12 mL/(kg·d)on day 1 which was increased to 24 mL/(kg·d)for the first 10 study days.The control group was fed 12 mL/(kg·d)for the first 14e48 hours.Then,the feeding volume increased by 24-36 mL/(kg·d)up to 140e160 mL/(kg·d)and maintained until the 10th day after birth.The incidence of feeding intolerance and NEC,duration of hospitalization,time to full enteral feedings,incidence of intrahepatic cholestasis,and the levels of gastrin and motilin in serum were assessed.Results:The incidence of feeding intolerance was significantly lower in the experimental group compared with the control group(15.87% vs.33.84%).There was a significant reduction in the incidence of NEC between the experimental and control groups(7.9% vs.16% in the control group).Conclusion:A protocol that prolongs small feeding volumes early in life can reduce the incidence and severity of NEC,but still warrants further study.展开更多
目的:评价强化母乳喂养的早产儿的早期生长情况,与非强化母乳、早产儿配方奶喂养的早产儿进行生长速率的比较。方法按照Cochrane图书馆检索策略,检索Cochrane图书馆、MEDLINE、EMBASE、PubMed、维普中文科技期刊数据库、中国期刊全...目的:评价强化母乳喂养的早产儿的早期生长情况,与非强化母乳、早产儿配方奶喂养的早产儿进行生长速率的比较。方法按照Cochrane图书馆检索策略,检索Cochrane图书馆、MEDLINE、EMBASE、PubMed、维普中文科技期刊数据库、中国期刊全文数据库、万方资源数据库,查阅会议记录、专题论文集、综述和检出文献等相关资料。收集关于强化母乳喂养早产儿的随机对照试验研究,进行文献筛选和质量评价,采用Rev Man 5.1软件进行Meta分析,计量资料采用加权均数差( WMD)及其95%CI表示。结果研究共纳入8篇文献。 Meta分析结果显示:强化母乳喂养早产儿早期体重增长速率、头围增长速率显著大于未强化母乳喂养早产儿,两组身长增长速率无显著性差异(体重:WMD=2.41,95%CI:1.01~3.82,P<0.001;身长:WMD=0.04,95%CI:-0.10~0.17,P=0.58;头围:WMD=0.12,95%CI:0.11~0.13,P<0.001);比较早产儿配方奶喂养早产儿,两组早期体重增长速率、身长增长速率、头围增长速率无显著性差异(体重:WMD=-1.28,95%CI:-3.62~1.06,P=0.28;身长:WMD=-0.05,95%CI:-0.27~0.18,P=0.68;头围:WMD=-0.01,95%CI:-0.06~0.04,P=0.73)。结论强化母乳喂养能较好地促进早产儿早期生长,可作为首选的喂养方式。展开更多
目的系统评价人乳喂养对极低出生体质量儿(VLBWI)早产儿视网膜病变(ROP)发病率的影响。方法利用万方、中国知网、PubMed、MEDLINE、EMBASE、CINAHL、Cochrane Central Register of Clinical Trials等数据库,检索1990年后发表的关于出生...目的系统评价人乳喂养对极低出生体质量儿(VLBWI)早产儿视网膜病变(ROP)发病率的影响。方法利用万方、中国知网、PubMed、MEDLINE、EMBASE、CINAHL、Cochrane Central Register of Clinical Trials等数据库,检索1990年后发表的关于出生时胎龄≤28周和/或出生体质量≤1500g的VLBWI人乳喂养与ROP发病率关系的文献,研究设计包括纯人乳(EHM)与早产儿配方奶(EPTF)、部分人乳与EPTF、高剂量人乳与低剂量人乳喂养婴儿的ROP发病率比较,共有29篇文献纳入研究。结果2项随机试验、5项观察性研究分别报道了EHM与EPTF喂养ROP发病率比较的结果,差异均无统计学意义(均P>0.05);其中3项研究报道了EHM与EPTF喂养严重ROP发病率比较的结果,显示EHM喂养能降低严重ROP发病率(RR=0.22,RD=-0.08,OR=0.20,P<0.05)。6项观察性研究报道了部分人乳与EPTF喂养ROP发病率比较的结果,显示差异无统计学意义(P>0.05),其中3项研究报道了部分人乳与EPTF喂养严重ROP发病率比较的结果,差异亦无统计学意义(P>0.05)。4项随机试验报道了高剂量与低剂量人乳喂养ROP发病率比较的结果,显示差异无统计学意义(P>0.05);19项观察性研究报道了高剂量与低剂量人乳喂养ROP发病率比较的结果,显示高剂量人乳喂养能降低ROP发病率(RR=0.82,RD=-0.03,OR=0.75,P<0.05);其中13项研究报道了高剂量与低剂量人乳喂养严重ROP发病率比较的结果,显示高剂量人乳喂养能降低严重ROP发病率(RR=0.66,RD=-0.02,OR=0.64,P<0.05)。结论EHM或高剂量人乳喂养可能降低VLBWI发生ROP的风险。展开更多
基金The study was funded by the Zhejiang Provincial Traditional Chinese Medicine Administration of China(approval number 2011ZB083)the Quality of Nursing Practice Project of the Chinese Medical Association.
文摘Objective:To study the effects of prolonging small feeding volumes early in life on the incidence of necrotizing enterocolitis(NEC)in very low birth weight(VLBW)preterm infants.Methods:A total of 128 VLBW infants who could not be breastfed were assigned into the experimental group(63 cases)and the control group(65 cases)using a random number table.The experiment group was fed 12 mL/(kg·d)on day 1 which was increased to 24 mL/(kg·d)for the first 10 study days.The control group was fed 12 mL/(kg·d)for the first 14e48 hours.Then,the feeding volume increased by 24-36 mL/(kg·d)up to 140e160 mL/(kg·d)and maintained until the 10th day after birth.The incidence of feeding intolerance and NEC,duration of hospitalization,time to full enteral feedings,incidence of intrahepatic cholestasis,and the levels of gastrin and motilin in serum were assessed.Results:The incidence of feeding intolerance was significantly lower in the experimental group compared with the control group(15.87% vs.33.84%).There was a significant reduction in the incidence of NEC between the experimental and control groups(7.9% vs.16% in the control group).Conclusion:A protocol that prolongs small feeding volumes early in life can reduce the incidence and severity of NEC,but still warrants further study.
文摘目的:评价强化母乳喂养的早产儿的早期生长情况,与非强化母乳、早产儿配方奶喂养的早产儿进行生长速率的比较。方法按照Cochrane图书馆检索策略,检索Cochrane图书馆、MEDLINE、EMBASE、PubMed、维普中文科技期刊数据库、中国期刊全文数据库、万方资源数据库,查阅会议记录、专题论文集、综述和检出文献等相关资料。收集关于强化母乳喂养早产儿的随机对照试验研究,进行文献筛选和质量评价,采用Rev Man 5.1软件进行Meta分析,计量资料采用加权均数差( WMD)及其95%CI表示。结果研究共纳入8篇文献。 Meta分析结果显示:强化母乳喂养早产儿早期体重增长速率、头围增长速率显著大于未强化母乳喂养早产儿,两组身长增长速率无显著性差异(体重:WMD=2.41,95%CI:1.01~3.82,P<0.001;身长:WMD=0.04,95%CI:-0.10~0.17,P=0.58;头围:WMD=0.12,95%CI:0.11~0.13,P<0.001);比较早产儿配方奶喂养早产儿,两组早期体重增长速率、身长增长速率、头围增长速率无显著性差异(体重:WMD=-1.28,95%CI:-3.62~1.06,P=0.28;身长:WMD=-0.05,95%CI:-0.27~0.18,P=0.68;头围:WMD=-0.01,95%CI:-0.06~0.04,P=0.73)。结论强化母乳喂养能较好地促进早产儿早期生长,可作为首选的喂养方式。
文摘目的系统评价人乳喂养对极低出生体质量儿(VLBWI)早产儿视网膜病变(ROP)发病率的影响。方法利用万方、中国知网、PubMed、MEDLINE、EMBASE、CINAHL、Cochrane Central Register of Clinical Trials等数据库,检索1990年后发表的关于出生时胎龄≤28周和/或出生体质量≤1500g的VLBWI人乳喂养与ROP发病率关系的文献,研究设计包括纯人乳(EHM)与早产儿配方奶(EPTF)、部分人乳与EPTF、高剂量人乳与低剂量人乳喂养婴儿的ROP发病率比较,共有29篇文献纳入研究。结果2项随机试验、5项观察性研究分别报道了EHM与EPTF喂养ROP发病率比较的结果,差异均无统计学意义(均P>0.05);其中3项研究报道了EHM与EPTF喂养严重ROP发病率比较的结果,显示EHM喂养能降低严重ROP发病率(RR=0.22,RD=-0.08,OR=0.20,P<0.05)。6项观察性研究报道了部分人乳与EPTF喂养ROP发病率比较的结果,显示差异无统计学意义(P>0.05),其中3项研究报道了部分人乳与EPTF喂养严重ROP发病率比较的结果,差异亦无统计学意义(P>0.05)。4项随机试验报道了高剂量与低剂量人乳喂养ROP发病率比较的结果,显示差异无统计学意义(P>0.05);19项观察性研究报道了高剂量与低剂量人乳喂养ROP发病率比较的结果,显示高剂量人乳喂养能降低ROP发病率(RR=0.82,RD=-0.03,OR=0.75,P<0.05);其中13项研究报道了高剂量与低剂量人乳喂养严重ROP发病率比较的结果,显示高剂量人乳喂养能降低严重ROP发病率(RR=0.66,RD=-0.02,OR=0.64,P<0.05)。结论EHM或高剂量人乳喂养可能降低VLBWI发生ROP的风险。