Darmstadt Gary L, Saha Samir K, Ahmed A S M Nawshad Uddin, Ahmed Saifuddin, Chowdhury M A K Azad, Law Paul A, Rosenberg Rebecca E, Black Robert E, Santosham Mathuram
Department of International Health E8153, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe St, Baltimore, MD 21205, USA.
Pediatrics. 2008 Mar;121(3):522-9. doi: 10.1542/peds.2007-0213.
Skin barrier therapy during the neonatal period, when the skin barrier is most highly compromised and the risk of death is greatest, has been shown to have a number of potential benefits, including reduced risk of nosocomial sepsis. Topical application of emollients that augment skin barrier function was evaluated as a strategy for improving survival rates among hospitalized preterm infants in Bangladesh.
A prospective, randomized, controlled, clinical trial was conducted in the special care nursery at Dhaka Shishu (Children) Hospital, the largest tertiary care children's hospital in Bangladesh. Preterm infants (gestational age: < or = 33 weeks; N = 497) received daily topical applications of sunflower seed oil or Aquaphor ointment. Neonatal mortality rates were compared in an intent-to-treat analysis with a control group that did not receive emollient therapy.
Treatment with sunflower seed oil resulted in a statistically significant 26% reduction in mortality rates, compared with infants not receiving topical emollient therapy. Aquaphor therapy also significantly reduced mortality rates, by 32%.
Topical therapy with skin barrier-enhancing emollients improved survival rates among preterm hospitalized infants in Bangladesh. This study provides strong evidence for the implementation of topical therapy for high-risk preterm neonates in developing countries.
新生儿期皮肤屏障最为脆弱且死亡风险最高，此时进行皮肤屏障治疗已显示出诸多潜在益处，包括降低医院感染性败血症的风险。本研究评估了局部应用增强皮肤屏障功能的润肤剂，作为提高孟加拉国住院早产儿存活率的一种策略。
在孟加拉国最大的三级护理儿童医院达卡儿童医院的特殊护理病房开展了一项前瞻性、随机、对照临床试验。早产儿（胎龄：≤33周；N = 497）每日接受局部涂抹葵花籽油或凡士林软膏。在一项意向性分析中，将未接受润肤剂治疗的对照组与接受治疗的新生儿死亡率进行比较。
与未接受局部润肤剂治疗的婴儿相比，使用葵花籽油治疗使死亡率在统计学上显著降低了26%。凡士林治疗也使死亡率显著降低了32%。
在孟加拉国，局部应用增强皮肤屏障的润肤剂可提高住院早产儿的存活率。本研究为在发展中国家对高危早产新生儿实施局部治疗提供了有力证据。
