目的 观察初乳口腔免疫治疗对早产极低出生体重儿临床预后的影响,以期为早产儿的救治提供依据。方法 前瞻性纳入2015年1月-2016年12月入住南京医科大学附属无锡妇幼保健院新生儿重症监护室(NICU)的极低出生体重儿89例,分为口腔免疫治疗组(n=59)和对照组(n=30),分别予初乳或生理盐水进行鼻咽部滴注3 d。收集临床资料及转归并分析。结果 口腔免疫治疗组临床败血症的发生率为8.5%,低于对照组(26.7%),差异有统计学意义(P＜0.05)。两组间确诊败血症、坏死性小肠结肠炎(NEC)、早产儿视网膜病变(ROP)、脑室周围-脑室内出血(PIVH)、支气管肺发育不良(BPD)、住院天数、出院体重及临床转归的比较,差异均无统计学意义(P均＞0.05)。结论 初乳口腔免疫治疗可降低临床败血症的发生率,并不降低确诊败血症、NEC、ROP、PIVH、BPD的发生率。
Abstract
Objective To assess the effect of colostrum as oral immune therapy on clinical outcomes in very low birth weight preterm infants, in order to provide evidence for the treatment of preterm infants.Methods Totally 89 preterm infants with very low birth weight in the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University from January 2015 to December 2016 were enrolled in this study, and were divided into oral immune therapy group(n=59) and control group(n=30). Participants received colostrums or normal saline via oropharyngeal route for 3 days. Clinical data during hospitalization and prognostic indicators were collected and analyzed.Results The incidence of clinical sepsis was 8.5% in the oral immune therapy group, significantly lower than that in control group (26.7%)(P＜0.05). However, there were no significant differences on the incidence rates of proven sepsis, necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), periventricular-intraventricular hemorrhage (PIVH) and bronchopulmonary dysplasia (BPD), hospitalization days, body weight at discharge and clinical prognosis(all P＞0.05).Conclusion Colostrum as oral immune therapy can reduce the incidence of clinical sepsis, but not reduce the incidence rates of proven sepsis, NEC, ROP, PIVH and BPD.
关键词
初乳 /
口腔免疫治疗 /
极低出生体重 /
早产儿
Key words
colostrum /
oral immune therapy /
very low birth weight /
preterm infants
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基金
江苏省妇幼保健重点学科建设项目(FXK201213);无锡市“科教强卫工程”医学重点学科建设项目(ZDXK003)、青年医学人才项目(QNRC039);无锡市科技发展医疗卫生指导性项目(CSZON1723);中国疾病预防控制中心妇幼保健中心合生元母婴营养与护理研究基金项目(2017BINCMCF34);无锡市卫计委妇幼健康科研项目(FYKY201505);南京医科大学科技发展基金面上项目(2015NJMU169);无锡市医院管理中心项目(YGZXZ1528)。
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