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【目的】评价口服不同剂量红霉素对早产儿喂养不耐受(feeding intolerance,FI)的治疗效果及可能存在的副作用,尤其对极低出生体重早产儿FI的治疗作用。【方法】选取2008年1月1日-2010年3月31日在16家三甲医院新生儿科住院并诊断为FI的早产儿,随机分为3组:红霉素大剂量组(第8～10日龄起口服红霉素12.5mg/kg,q8h,疗程7～10d)、红霉素小剂量组(口服红霉素5mg/kg,给药方法同上)、对照组(完全不用胃肠动力调节药物)。比较各项喂养相关指标、宫外生长迟缓发生率等,并评估药物副作用。【结果】入组极低体重儿46例,大剂量组11例,小剂量组22例,对照组13例。两治疗组肠内热卡达基础热卡的日龄及体重开始增长时肠内热卡比例较对照组明显改善,大剂量组体重宫外生长迟缓发生率较对照组明显降低。所有治疗组患儿随访6个月均未见明显红霉素副作用。【结论】本研究中选取的两种剂量红霉素口服对极低出生体重早产儿FI均有一定治疗作用,大剂量略优于小剂量。所采用的红霉素治疗方案未见明显副作用。
【Objective】 To evaluate the therapeutic effect and possible side effects of different doses of erythromycin on feeding intolerance (FI) in preterm infants, especially for the treatment of very low birth weight premature infants. 【Methods】 Preterm infants admitted to Department of Neonatology, 16 First Anesthesiologists from January 1, 2008 to March 31, 2010 were enrolled and randomly divided into 3 groups: high dose erythromycin group (8-10 Erythromycin 12.5mg / kg, q8h, 7 ~ 10d after treatment), erythromycin low dose group (oral erythromycin 5mg / kg, method of administration as above), control group drug). Compare the various feeding-related indicators, the incidence of ectopic growth retardation, etc., and evaluate drug side effects. 【Results】 Among the 46 children with very low birth weight, 11 received high dose, 22 received low dose and 13 received control. Compared with the control group, the ratio of enteral caloric value in the two treatment groups was obviously improved at the beginning of the enteral heat-caldarum heat card and the weight gain began to increase. The incidence of post-uterine growth retardation in the high-dose group was significantly lower than that in the control group. All treatment groups were followed up for 6 months showed no obvious side effects of erythromycin. 【Conclusion】 The two doses of erythromycin selected in this study have a certain therapeutic effect on the very low birth weight premature infants FI. The high dose is slightly better than the low dose. Erythromycin used in the treatment of no obvious side effects.