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目的:探讨小剂量红霉素对早产儿胃食管反流及喂养不耐受的影响。方法:200例胎龄≤34周的早产儿随机分为干预组和对照组各100例,干预组给予红霉素剂量(2.5 mg·kg~(-1)),用0.9%氯化钠溶液配成浓度为5 mg·ml~(-1)溶液鼻饲q6h,对照组给予等量0.9%氯化钠溶液鼻饲。通过24 h食管pH测定及喂养耐受情况评估,了解两组患儿胃食管反流情况。结果:200例患儿胃食管反流发生率为92.5%(185/200);鼻饲红霉素治疗后,干预组胃食管反流发生率从94%(94/100)降至32%(32/100),对照组从91%(91/00)降至77%(77/100),DeMeester评分干预组从36.9±10.8降至16.8±56.4,对照组从34.3±11.1降至29.0±10.8,两组比较差异均有统计学意义(P<0.01);干预组达到出生体重及喂奶量120 ml·kg~(-1)·d~(-1)的天数都比对照组平均提前4 d(P<0.01),静脉营养天数及胃储留次数均低于对照组(P<0.01)。结论:鼻饲小剂量红霉素可以降低胃食管反流的发生率,建议尽早建立胃肠道喂养。
Objective: To investigate the effect of low dose erythromycin on gastroesophageal reflux and feeding intolerance in preterm infants. Methods: A total of 200 preterm infants with gestational age ≤34 weeks were randomly divided into intervention group and control group (n = 100). Erythromycin (2.5 mg · kg -1) was given to the intervention group with 0.9% sodium chloride solution Dubbed the solution of 5 mg · ml ~ (-1) nasal feeding q6h, the control group given the same amount of 0.9% sodium chloride solution nasal feeding. Through 24 h esophageal pH determination and feeding tolerance assessment, understand the two groups of children with gastroesophageal reflux. Results: The incidence of gastroesophageal reflux was 92.5% (185/200) in 200 children. The incidence of gastroesophageal reflux in the intervention group decreased from 94% (94/100) to 32% (32/32) after nasal administration of erythromycin / 100) in the control group decreased from 91% (91/00) to 77% (77/100) in the control group, from 36.9 ± 10.8 to 16.8 ± 56.4 in the DeMeester score group and from 34.3 ± 11.1 to 29.0 ± 10.8 in the control group The difference between the two groups was statistically significant (P <0.01); the average number of days of birth weight and feeding amount of 120 ml · kg -1 · d -1 in the intervention group was 4 days earlier than the control group P <0.01), the number of days of intravenous nutrition and the number of gastric storage were lower than the control group (P <0.01). Conclusion: Nasal feeding of low dose erythromycin can reduce the incidence of gastroesophageal reflux, it is recommended to establish gastrointestinal tract as soon as possible.