Michikata Kaori, Kodama Yuki, Kaneko Masatoki, Sameshima Hiroshi, Ikenoue Tsuyomu, Machigashira Seiro, Mukai Motoi, Torikai Motofumi, Nakame Kazuhiko
Department of Obstetrics and Gynecology, University of Miyazaki, Kiyotake, Miyazaki, Japan.
Department of Pediatric Surgery, Kagoshima University, Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan.
Pediatr Int. 2018 Aug;60(8):714-718. doi: 10.1111/ped.13606. Epub 2018 Jul 10.
Intestinal disorders are common in very low-birthweight infants. The purpose of this study was to evaluate the impact of prophylactic oral Gastrografin (diatrizoate acid) on meconium-related ileus (MRI) in extremely preterm infants.
This was a retrospective case-control study of infants born extremely preterm at <28 weeks of gestation and treated with diatrizoate acid (prophylactic group) or not (control group) in the periods 2007-2014 and 2000-2009, respectively. In the 2007-2014 period, 120 infants received prophylactic diatrizoate acid solution. From the 165 infants in the control group, we selected 120 infants matched for gestational age. Cases of death before 72 h of life or congenital abnormalities were excluded. Intestinal disorders, time until full enteral feeding, duration of hospital stay, mortality rate, and neurodevelopmental outcome were compared.
MRI occurred in six infants in the control group and in none of the infants in the prophylactic group (P = 0.039). Median time until full enteral feeding was 25 versus 22 days (P < 0.01), hospital stay was 142 versus 126 days (P < 0.01), and mortality rate for infants aged 24-27 weeks was 8.2% versus 0% (P = 0.021), respectively.
Prophylactic oral diatrizoate acid reduced MRI in extremely preterm infants without side-effects and decreased the mortality rate of infants born at 24-27 weeks, and is thus beneficial in extremely preterm infants.
肠道疾病在极低出生体重儿中很常见。本研究的目的是评估预防性口服泛影葡胺（泛影酸）对极早产儿胎粪性肠梗阻（MRI）的影响。
这是一项回顾性病例对照研究，分别对2007 - 2014年和2000 - 2009年出生孕周<28周的极早产儿进行研究，其中一组接受泛影酸治疗（预防组），另一组未接受治疗（对照组）。在2007 - 2014年期间，120名婴儿接受了预防性泛影酸溶液治疗。从对照组的165名婴儿中，我们选取了120名孕周匹配的婴儿。排除出生后72小时内死亡或有先天性异常的病例。比较两组的肠道疾病、完全经口喂养时间、住院时间、死亡率和神经发育结局。
对照组有6名婴儿发生胎粪性肠梗阻，预防组无婴儿发生（P = 0.039）。完全经口喂养的中位时间分别为25天和22天（P < 0.01），住院时间分别为142天和126天（P < 0.01），24 - 27周龄婴儿的死亡率分别为8.2%和0%（P = 0.021）。
预防性口服泛影酸可降低极早产儿的胎粪性肠梗阻发生率，且无副作用，并降低了24 - 27周出生婴儿的死亡率，因此对极早产儿有益。
