微生态制剂对婴幼儿肺炎继发抗生素相关性腹泻的防治作用

Clinical research of microecological preparation in preventing and treating antibiotic associated diarrhea in infant pneumonia

目的探讨微生态制剂对婴幼儿肺炎继发抗生素相关性腹泻（AAD）的防治作用。方法选择年龄为1个月-3岁的婴幼儿肺炎住院患者360例，均静脉应用抗菌药物且连续治疗时间〉5d，排除慢性胃肠道疾病。随机分成3组，即对照组（A组，60例），双歧三联活菌预防组（B组，150例）和布拉酵母菌预防组（C组，150例）。入选患儿在抗感染治疗的同时，A组不予任何微生态制剂，B组加用双歧三联活菌，C组加用布拉酵母菌，观察各组患儿AAD的发生情况，并评价各组疗效。结果A组患儿AAD发生率（41．67％）明显高于B（19．33％）、C组（17．33％），但各组患儿AAD严重程度之间差异无统计学意义（P〉0．05）；AAD持续时间C组最短，B组次之，A组最长，组间比较差异有统计学意义；抗腹泻总有效率A组不如B、C组。结论应用抗菌药物治疗的同时，口服微生态制剂双歧三联活菌、布拉酵母菌均能有效降低AAD的发生，缩短腹泻持续时间，布拉酵母菌在缩短腹泻持续时间效果更为明显。

AIM To investigate the effect of microecological preparation for the prevention and treatment of an- tibiotic-associated diarrhea（AAD）in infant pneumonia. METHODS A total of 360 hospitalized infant patients（ 1 month-3 years） with pneumonia but without gastroenteric disease received antibiotics intravenously for more than 5 days. All pa- tients were divided into 3 groups randomly. Group A was control group（60 patients）. Group B received antibiotics treat- ment combined with live bifidobacterium, lactobacillus and enterococcus powder orally （150 patients）. Group C received Saccharomyces boulardii Sachets （ 150 patients）. The incidences and curative effect of AAD in 2 test groups were com- pared respectively with those of control group. RESULTS The incidences of AAD in the 2 test groups were both obvi- ously lower than those in control group. The difference of diarrhea severity scores in 3 groups was not significant （ P 〉 0.05）. The duration of diarrhea in group C was shorter than that in group B and group A, and group B was shorter than group A. The results showed a statistical significance difference （P 〈 0. 001 ）. The total efficiency of anti-diarrhea in group A was lower than group B and C, but there was no difference between group B and C. CONCLUSION Both bifi- dobacterium, lactobacillus, enterococcus powder and Saccharomyces boulardii Sachets can effectively prevent the inci- dence of AAD and shorten the duration of diarrhea, Saccharomyces boulardii Sachets has more significant effect in short- ening the duration of diarrhea.