微生态制剂防治婴幼儿肺炎继发性腹泻的临床分析

Clinical analysis about probiotics in prevention of pneumonia secondary diarrhea in infants

目的探讨婴幼儿肺炎继发性腹泻时微生态制剂的正确使用方法,为临床提供帮助。方法采用前瞻性的临床研究方法,对482例婴幼儿肺炎住院病例按入院顺序随机分为3组,治疗1组病例在肺炎治疗初始即同时使用微生态制剂,治疗2组病例在肺炎治疗过程中出现腹泻症状时才开始使用微生态制剂,对照组病例不使用微生态制剂,分别治疗3天,观察各组患儿的继发性腹泻的发病情况和疗效情况,比较各组间差异。结果各组患儿发生继发性腹泻的百分比分别为:治疗1组52.7%(98/186),治疗2组55.7%(88/158),对照组66.7%(92/138),治疗1组与治疗2组及对照组比较继发性腹泻发病情况,差异有统计学意义(χ2=6.700,P<0.05)。进一步比较预防性服用微生态制剂(治疗1组)和未预防性服用微生态制剂(治疗2组+对照组)对继发性腹泻的发病情况的影响,差异无统计学意义(χ2=3.087,P>0.05)。各组患儿间继发性腹泻疗效比较,差异有统计学意义(Hc=101.831,P<0.01)。结论①提前使用微生态制剂并未能达到预防婴幼儿肺炎继发性腹泻发生的作用。②当婴幼儿肺炎继发性腹泻发生后,正确使用微生态制剂可以明显缩短腹泻的病程并减轻其症状。③治疗婴幼儿肺炎继发性腹泻时,使用不同的微生态制剂的疗效无明显差异,但选用微生态制剂的剂型、味道等因素明显决定幼儿对药物的耐受性和适应性,也可影响药物的疗效。

Objective To investigate the proper use of probiotics in infant diarrhea secondary to pneumonia for clinical help.Methods A prospective clinical study method was conducted on 482 cases of infant pneumonia admitted to the hospital who were randomly divided into three groups,treatment group 1,the cases in the initial treatment for pneumonia were used probiotics,treatment group 2,probiotics were used in the process of diarrhea,the control group of patients did not use probiotics,all were treated for three days.Secondary cases and efficacy of the prevalence of diarrhea cases between groups were compared.Results The occurrence of secondary diarrhea of treatment group 1,treatment group 2 and control group were 52.7%（98/186）,55.7%（88/158）,66.7%（92/138）,treatment group 1,treatment group 2 and control group showed significant difference in secondary diarrhea incidence（χ2=6.700,P〈0.05）.Further to compare the incidence of secondary effects of diarrhea between the preventive doses of probiotics（treatment group 1） and non-preventive doses of probiotics（treatment group 2＋group）,the difference was not statistically significant（χ2=3.087,P〈0.05）.Treatment group 1,treatment group 2 and control group were compared in the situation of secondary effects of diarrhea,the difference was statistically significant（Hc=101.831,P〈0.01）.Conclusion ①Early use of probiotics failed to achieve the prevention of diarrhea in infants secondary with pneumonia and its role.②For infants and young children with pneumonia after the occurrence of diarrhea,proper use of probiotics can shorten the duration of diarrhea and reduce its symptoms.③In the treatment of pneumonia secondary diarrhea in infants,the use of different probiotics shows no significant difference in efficacy,but the selections of probiotics dosage form,taste and other factors are the decision of children to drug tolerance and adaptability,but also affect the drug efficacy.