Soll R F, Edwards W H
Department of Pediatrics, University of Vermont College of Medicine, A-121 Medical Alumni Building, Burlington, Vermont 05405-0068, USA.
Cochrane Database Syst Rev. 2000(2):CD001150. doi: 10.1002/14651858.CD001150.
This section is under preparation and will be included in the next issue.
To assess the effect of prophylactic application of emollient ointment in preterm infants.
Searches were made of the Oxford Database of Perinatal Trials, Medline (MeSH terms: ointment; limits: age groups, newborn infant; publication types, clinical trial), previous reviews including cross references, abstracts, conference and symposia proceedings, expert informants, and journal handsearching in the English language.
Randomized controlled trials which compared the effect of prophylactic application of emollient ointment to routine care or as needed topical therapy in preterm infants are included in this review.
Data regarding clinical outcomes including transepidermal water loss, skin condition, fluid intake, suspect infection and proven nosocomial infection were excerpted from the reports of the clinical trials by the reviewers. Data analysis was done in accordance with the standards of the Cochrane Neonatal Review Group.
Two randomized trials which compared prophylactic application of ointment to routine skin care or as needed topical ointment therapy were identified. Lane (1993) noted improved skin condition in infants receiving topical application of emollient ointment. In the study of Nopper and coworkers (1996), prophylactic application of ointment significantly decreased transepidermal water loss during the first six hours after initial application. Skin condition was noted to be improved during the first 1-2 weeks. Surveillance cultures demonstrated less bacterial colonization during the two week study. A significant decrease in suspect and proven infection was noted. Fewer infants were evaluated for sepsis among the group who received prophylactic application of ointment (relative risk 0. 50, 95% CI 0.27, 0.93; risk difference -0.30, 95% CI -0.54, -0.06). Both studies reported on the incidence of proven nosocomial infection. A trend towards a decrease in the risk of proven nosocomial infection was noted in infants who received prophylactic application of emollient ointment (typical relative risk 0.29, 95% CI 0.07, 1.16, typical risk difference -0.13, 95% CI -0.25, -0.01).
REVIEWER'S CONCLUSIONS: In two small studies, prophylactic application of emollient ointment decreased transepidermal water loss, decreased the severity of dermatitis, and decreased the risk of suspect sepsis and proven sepsis. Further clinical studies are warranted to validate these results.
本节正在编写中，将在下一期发表。
评估预防性使用润肤软膏对早产儿的影响。
检索了牛津围产期试验数据库、Medline（医学主题词：软膏；限定条件：年龄组，新生儿；出版物类型，临床试验），以及以往的综述（包括交叉参考文献、摘要、会议和专题讨论会记录）、专家提供的信息，并对英文期刊进行了手工检索。
本综述纳入了比较预防性使用润肤软膏与常规护理或按需局部治疗对早产儿影响的随机对照试验。
综述人员从临床试验报告中摘录了有关临床结局的数据，包括经皮水分丢失、皮肤状况、液体摄入量、疑似感染和确诊的医院感染。数据分析按照Cochrane新生儿综述组的标准进行。
确定了两项比较预防性使用软膏与常规皮肤护理或按需局部软膏治疗的随机试验。莱恩（1993年）指出，接受局部使用润肤软膏的婴儿皮肤状况有所改善。在诺珀及其同事（1996年）的研究中，预防性使用软膏在初次使用后的前六个小时显著降低了经皮水分丢失。在最初的1-2周内，皮肤状况有所改善。监测培养显示，在为期两周的研究中细菌定植减少。疑似和确诊感染显著减少。在接受预防性使用软膏的组中，接受败血症评估的婴儿较少（相对风险0.50，95%可信区间0.27，0.93；风险差值-0.30，95%可信区间-0.54，-0.06）。两项研究均报告了确诊的医院感染发生率。在接受预防性使用润肤软膏的婴儿中，确诊的医院感染风险有降低趋势（典型相对风险0.29，95%可信区间0.07，1.16，典型风险差值-0.13，95%可信区间-0.25，-0.01）。
在两项小型研究中，预防性使用润肤软膏降低了经皮水分丢失，减轻了皮炎的严重程度，并降低了疑似败血症和确诊败血症的风险。有必要进行进一步的临床研究以验证这些结果。
