使用甘油类泻药是否会降低早产儿的喂养不耐受情况？
Does the use of glycerin laxatives decrease feeding intolerance in preterm infants?
作者信息
Shah Vibhuti, Chirinian Nevart, Lee Shoo
机构信息
Department of Paediatrics, Mount Sinai Hospital; ; Department of Paediatrics and Department of Health Policy, Management and Evaluation, University of Toronto;
出版信息
Paediatr Child Health. 2011 Nov;16(9):e68-70.
BACKGROUND
Glycerin laxatives are often prescribed in the neonatal population for meconium evacuation and to promote enteral feeding. However, the literature regarding their effectiveness has not been systematically reviewed.
OBJECTIVE
To assess the effectiveness of glycerin enema or suppository in preventing feeding intolerance in preterm infants at ≤32 weeks' gestational age or weighing ≤1500 g at birth.
METHODS
The Medline, Embase, Cochrane Library, Scopus and Web of Science databases were searched to identify studies that evaluated glycerin enemas/suppositories for feeding intolerance. Using the Evidence Evaluation Worksheet adapted from the American Heart Association's International Liaison Committee on Resuscitation, eligible studies were scored for quality, level of evidence and direction of support.
RESULTS
Two clinical studies that evaluated meconium evacuation and feeding intolerance were included. One study showed no difference in the time to complete meconium evacuation or establishment of full enteral feeds, while the other showed that the times to first meconium passage and full enteral feeding were significantly shorter, and the rate of sepsis was lower in the glycerin enema group.
CONCLUSION
The evidence regarding the effectiveness of glycerin laxatives for improving feeding tolerance is inconclusive in infants at ≤32 weeks' gestational age or weighing ≤1500 g at birth.
背景
甘油灌肠剂常用于新生儿群体，以促进胎粪排出并促进肠内喂养。然而，关于其有效性的文献尚未得到系统综述。
目的
评估甘油灌肠剂或栓剂对孕周≤32周或出生体重≤1500g的早产儿喂养不耐受的预防效果。
方法
检索Medline、Embase、Cochrane图书馆、Scopus和科学网数据库，以识别评估甘油灌肠剂/栓剂对喂养不耐受影响的研究。使用改编自美国心脏协会国际复苏联络委员会的证据评估工作表，对符合条件的研究进行质量、证据水平和支持方向评分。
结果
纳入两项评估胎粪排出和喂养不耐受的临床研究。一项研究显示，在完成胎粪排出或建立完全肠内喂养的时间上没有差异，而另一项研究表明，甘油灌肠剂组首次排出胎粪和完全肠内喂养的时间显著缩短，败血症发生率较低。
结论
对于孕周≤32周或出生体重≤1500g的婴儿，关于甘油灌肠剂改善喂养耐受性有效性的证据尚无定论。
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