孕30 - 33周婴儿早期纯肠内喂养：一项随机对照试验。
Early exclusive enteral feeding in 30-33 weeks gestation infants: a randomized controlled trial.
作者信息
Alshaikh Belal N, Hassan Ossama, Alburaki Wissam, Dharel Dinesh, Elsharkawy Adel, Singal Nalini, Yusuf Kamran, Awad Essa Al
机构信息
Neonatal Gastroenterology and Nutrition Program, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
出版信息
J Perinatol. 2025 Feb 2. doi: 10.1038/s41372-025-02217-0.
OBJECTIVE
To evaluate feasibility and efficacy of early exclusive enteral feeding (EEEF) in reducing time to achieve full enteral feeds.
METHODS
A pragmatic randomized controlled trial of infants born at 30-33 weeks gestation. Infants were randomly assigned to receive EEEF (60-80 mL/kg/day) or conventional feeding (20-30 mL/kg/day) with intravenous fluids after birth. Feed volumes were increased by 20-30 mL/kg/day. Primary outcome was time to reach full enteral feeds.
RESULTS
Seventy infants were enrolled. Infants in EEEF group achieved full feeds sooner [Mean difference (MD) -1.2 (95%CI -1.8, -0.7)], required fewer hours of parenteral nutrition [0 (IQR 0, 19) vs. 91 (IQR 48, 132) hours, P < 0.001], had less need for central venous access (11.4% vs. 37.1%, P = 0.01) and had shorter hospital stays [MD -6.6 (95%CI -12.9, -0.2) days].
CONCLUSION
Early exclusive enteral feeding in 30-33 weeks gestation infants is feasible and reduces time required to achieve full enteral feeds and length of hospital stay.
TRIAL REGISTRATION
ClinicalTrials.gov: NCT03708068.
目的
评估早期纯肠内喂养（EEEF）在缩短实现完全肠内喂养时间方面的可行性和有效性。
方法
一项针对孕30 - 33周出生婴儿的实用随机对照试验。婴儿出生后被随机分配接受EEEF（60 - 80毫升/千克/天）或常规喂养（20 - 30毫升/千克/天）并补充静脉输液。喂养量每天增加20 - 30毫升/千克。主要结局是达到完全肠内喂养的时间。
结果
纳入70名婴儿。EEEF组婴儿更快实现完全喂养[平均差（MD）-1.2（95%置信区间-1.8，-0.7）]，所需肠外营养小时数更少[0（四分位间距0，19）对91（四分位间距48，132）小时，P < 0.001]，对中心静脉通路的需求更少（11.4%对37.1%，P = 0.01），住院时间更短[MD -6.6（95%置信区间-12.9，-0.2）天]。
结论
对孕30 - 33周的婴儿进行早期纯肠内喂养是可行的，可缩短实现完全肠内喂养所需时间及住院时间。
试验注册
ClinicalTrials.gov：NCT03708068。
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