【Cochrane简语概要】使用外用润肤剂预防早产儿感染

研究背景

早产儿（妊娠未满37周出生）易受血液和其他严重感染的影响，部分原因是他们未成熟的皮肤无法完全有效地阻挡微生物。涂抹润肤剂（软膏、乳霜或油）可以防止皮肤皲裂，从而预防微生物扩散到血液中并引起严重感染。

（图片来源于thl.fi）

研究特征

我们检索（更新至2021年1月）确定了22项符合条件的试验。总共有5578名婴儿参与。8项试验（2086名婴儿）探讨了使用外用软膏或乳霜对极早产儿（早产八周以上）的影响，这些婴儿大多照料于高收入国家的医院中。14项试验（3492名婴儿）评估了葵花及其他植物油的影响，这些试验大多在南亚的中低收入国家进行。除1项试验之外，其他试验都在医院进行。一项印度的大型试验（2249名婴儿）则在社区进行。

主要结果

经常在极早产儿皮肤上涂抹软膏或乳霜可能对严重感染或死亡的影响很小或没有作用。而使用葵花籽油和其他植物油可以減少侵入性感染，但对死亡率影响不大或没有影响。

证据质量

这些分析提供了润肤剂治疗对早产儿严重感染或死亡影响的低质量证据。由于这些干预措施大多价格低廉、容易获得，而且普遍可接受，因此应在中低收入国家的医疗保健机构和社区环境中进一步开展高质量的随机对照试验。

结论: 

润肤疗法对早产儿侵入性感染或死亡影响的证据质量较低。由于这些干预措施大多价格低廉、容易获得，而且普遍可接受，因此应在中低收入国家的医疗保健机构和社区环境中进一步开展高质量的随机对照试验。

作者: Cleminson J, McGuire W；译者：何宗蔚，审校：刘琴，重庆医科大学公共卫生与管理学院循证医学中心，Cochrane中国协作网成员单位；编辑排版：索于思、张晓雯，北京中医药大学循证医学中心，Cochrane中国协作网成员单位

相关文章链接

【Cochrane Plain Language Summary】Topical emollient for preventing infection in preterm infants

Background

Preterm infants (born before 37 weeks' gestation) are susceptible to bloodstream and other serious infections partly because their immature skin is not a fully effective barrier to micro-organisms. Applying emollient (ointment, cream, or oil) may protect against skin breakdown and thereby prevent micro-organisms from spreading into the bloodstream and causing serious infection.

Study characteristics

Our search (updated January 2021) identified 22 eligible trials. In total, 5578 infants participated. Eight trials (2086 infants) examined the effect of topical ointments or creams in very preterm infants (born more than eight weeks early) cared for in hospitals, mostly in high-income countries. Fourteen trials (3492 infants) assessed the effect of sunflower and other vegetable oils, mostly in low- or middle-income countries in south Asia. All but one of these trials was conducted in hospitals. One large trial in India (2249 infants) was based in the community.

Key results

Regular application of ointments or creams to the skin of very preterm infants may have little or no effect on serious infection or death. Application of sunflower and other vegetable oils may reduce invasive infection but have little or no effect on mortality.

Certainty of evidence

These analyses provide low certainty evidence about the effects of emollient therapy on serious infection or death in preterm infants. Since these interventions are mostly inexpensive, readily accessible, and generally acceptable, further good-quality randomised controlled trials in healthcare facilities, and in community-settings in low- or middle-income countries, may be justified.

Authors' conclusions: 

The level of certainty about the effects of emollient therapy on invasive infection or death in preterm infants is low. Since these interventions are mostly inexpensive, readily accessible, and generally acceptable, further good-quality randomised controlled trials in healthcare facilities, and in community settings in low- or middle-income countries, may be justified. 

想要报名成为Cochrane翻译志愿者，了解工作组，请关注北京中医药大学循证医学中心（Cochrane中国协作网成员单位-翻译传播工作组）公众号了解详情！

点击“阅读原文”，查看中英文完整摘要。