小儿肺炎继发性腹泻相关因素分析及微生态制剂的预防作用

Relative factors of secondary diarrhea in children with pneumonia and the prevention of probiotics on it

目的探讨小儿肺炎继发性腹泻的相关因素及微生态制剂的预防作用。方法回顾性分析2011年7月至2013年6月我院收治的300例肺炎患儿的临床资料。以应用抗生素的同时应用酪酸梭菌活菌散治疗的患儿为观察组(n=160例),以单纯采用抗生素治疗或住院3 d出现肺炎继发性腹泻后才加用酪酸梭菌活菌散的患儿为对照组(n=140例)。先采用单因素χ2检验筛选出与小儿肺炎继发性腹泻有关的因素,再采用非条件Logistic多因素回归分析其危险因素和保护因素。结果共有90例患儿发生继发性腹泻,其中观察组28例(17.5%),对照组62例(44.3%),观察组发生率明显低于对照组,差异具有统计学意义(χ2=4.882,P<0.05)。单因素χ2分析结果显示:患儿年龄、居住地、病情程度、血中性粒细胞比例、血红蛋白量、是否使用激素、是否使用微生态制剂、是否进行侵入性操作、住院时间与肺炎继发性腹泻有关。非条件Logistic回归模型多因素分析进一步筛选出3个危险因素[患儿年龄(χ2=14.121,P=0.000)、住院时间(χ2=11.533,P=0.002)、接受侵入性操作(χ2=6.828,P=0.009)]和1个保护因素[应用微生态制剂(χ2=12.474,P=0.001)]。结论年龄小、住院时间长以及接受侵入性操作可以增加肺炎患儿的继发性腹泻的发生率;采用微生态制剂治疗可以降低其发生率,提示其具有良好的预防作用。

Objective To investigate the relative factors of secondary diarrhea in children with pneumonia and discuss the prevention function of probiotics on it. Methods Clinical data from 300 pneumonia children with di-arrhea, seen between July 2011 and June 2013, were collected retrospectively. The patients who had been undertaken antibiotic in combination with live clostridium butyricum were grouped as observation group （n=160）. The patients who had been undertaken antibiotic treatment only or suffered diarrhea 3 days after hospitalization and added live clos-tridium butyricum were grouped as control group （n=140）. Chi-square test was used to screen out the factors which as-sociated with pneumonia children with diarrhea, then the unconditioned Logistic multifactor regression analysis was used to finger out the risk factors and protective factors. Results A total of 90 cases of children had secondary diar-rhea with 28 cases from observation group （17.5%） and 62 cases from control group （44.3%）. The incidence of obser-vation group was significantly lower than that of the control group （χ2=4.882, P〈0.05）. Age, place of residence, the de-gree of disease, blood neutrophils ratio, quantity of hemoglobin, using hormones, microecologics, invasive operation and hospitalization time were associated with pneumonia secondary diarrhea by Chi-square test analysis. Uncondition-al Logistic regression model analysis further revealed three risk factors：age （χ2=14.121, P=0.000）, the length of hospi-tal stay （χ2=11.533, P=0.002）, and accepting the invasive operation （χ2=6.828, P=0.009）, and one protection factors：application of microecologics （χ2=12.474, P〈0.001）. Conclusion Younger child, long hospitalization and invasive operation can increase the incidence of secondary diarrhea in pneumonia children, while using probiotics can reduce it. Thus it prompt that probiotics may prevent diarrhea.