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目的探讨不同喂养对新生儿坏死性小肠结肠炎(NEC)发病率的影响,并分析其对新生儿生长发育的不同作用。方法应用Donor human milk、formula milk、premature、low birth weight等关键词检索Pubmed、EMBASE、Ovid、the Cochrane Library和中国生物医学文献数据库发表的文章,并同时检索相关参考文献,对资料进行Meta分析。结果不同国家的7项研究共16篇文献被纳入此研究。共纳入病例1012例,其中单纯使用捐赠母乳或配方奶者669例,同时进行母乳喂养者343例,荟萃分析发现应用捐赠母乳可降低NEC的发病风险,合并的相对风险度RR=0.34,95%CI(0.16～0.71)。但是其对早产儿和低出生体重儿生长发育的作用弱于配方奶。结论捐赠母乳应该得推广,从而在降低NEC和胃肠不耐受的同时使早产儿和低出生体重儿更快地成长。
Objective To investigate the effects of different feeding on the incidence of Neonatal necrotizing enterocolitis (NEC) and to analyze its different effects on the growth and development of neonates. Methods Pubmed, EMBASE, Ovid, the Cochrane Library and Chinese Biomedical Literature Database were searched for key words of Donor human milk, formula milk, premature, low birth weight and so on. At the same time, relevant references were searched and the data were analyzed by Meta-analysis. Results A total of 16 articles from 7 studies in different countries were included in this study. A total of 1012 cases were enrolled. Among them, 669 cases of donated breast milk or formula were used alone and 343 cases were breastfeeding simultaneously. Meta-analysis showed that the application of donated breast milk can reduce the risk of NEC. The relative risk of RR was 0.34, 95% CI (0.16 ~ 0.71). However, its effect on growth and development of premature and low birth weight children is weaker than that of formula milk. Conclusion The donation of breast milk should be promoted to allow faster growth of preterm and low birth weight infants while reducing NEC and gastrointestinal intolerance.