微生态制预防治早产儿坏死性小肠结肠炎的作用研究

Effect of probiotics in the prevention of necrotizing enterocolitis in premature infants

目的观察应用微生态制剂(金双歧)预防早产儿坏死性小肠结肠炎(NEC)的有效性。方法 2011年1月至2012年6月在成都市妇女儿童中心医院新生儿科住院治疗的279例生后存活7 d并且开始胃肠道喂养的早产儿,预防组142例,对照组137例。预防组在对照组常规治疗原发病基础上每日给予双歧三联活菌片,每次0.5片,每日3次,用药至出院。观察治疗期间两组发生NEC的情况,对两组治疗前及治疗后7 d分别留取新鲜粪便标本进行细菌学检查。结果预防组NEC发病率为1.41%,对照组NEC发生率为5.84%,两组比较差异有统计学意义(P<0.05)。治疗后7 d两组患儿肠道细菌总数、杆菌、球菌总数及杆球菌比值差异均有统计学意义(P<0.05)。预防组治疗前、治疗后7 d杆球菌比值差异无统计学意义(P>0.05)。结论给予早产儿预防性口服微生态制剂能够降低NEC发病率。其机制可能与口服微生态制剂后促进新生儿肠道正常菌群的定植和优势化、维持肠道正常菌群比率有关。

Objective To explore the preventive effects of microecological preparation（Jinshuangqi,Golden Bifid） on neonatal necrotizing enterocolitis（NEC） in premature infants.Methods The clinical data of 279 inpatients who had survived ≥ 7 d after birth and accepted enteral feeding in Chengdu Women and Childern′s Medical Center from January 2011 to June 2012 were retrospectively analyzed.Results The NEC incidence rate of the prevention group was 1.41%,while the control group was 5.84%.There was statistical significance in the comparison of the two groups（P〈0.05）.In addition,7 days after treatment,the differences in total numbers of intestinal bacteria,bacilli and cocci as well as the ratios of bacilli and cocci of the two groups were significantly different（P〈0.01）.The difference of the ratio of bacilli/cocci in the control group before and after treatment didn＇t show any statistical significance（P〈0.05）.Conclusion Probiotics,given orally for a purpose of prevention,can reduce the incidence rate of NEC in preterm infants,possibly because it can promote the colonization and predomination of the newborn infants＇ normal intestinal flora,and maintain the ratio of normal intestinal flora.