布拉氏酵母菌预防肠套叠手术复位继发性腹泻临床研究

Clinical research in Saccharomyces boulardii to prevent secondary diarrhea after surgical reduction for intussusception

目的观察布拉氏酵母菌对急性肠套叠患儿手术复位后继发腹泻的治疗效果。方法仅仅只是进行(即未行肠修补,肠切除吻合术)急诊肠套叠手术复位的患儿,术后随机分为观察组(术后可进食后即予以布拉氏酵母菌)94例。对照组(术后进食未予以布拉氏酵母菌)88例。入院后所有患儿即查大便常规及隐血、轮状病毒抗原及相关术前检查。术后注意患儿大便性状改变,如有腹泻立即复查大便常规及隐血,复查轮状病毒抗原。结果观察组和对照组肠套叠手术后继发腹泻发生率分别为6.3%(6/94)、12.5%(11/88),两组比较差异有统计学意义(χ2=4.63,P=0.03),术后腹泻时间分别为(3.24±1.22)d,(4.63±1.14)d,两组比较差异有统计学意义(F=5.14,P=0.022)。全部患儿均治愈出院,均未发生肠套叠复发、伤口感染、裂开、过敏等情况,出院时大便正常。结论微生态制剂布拉氏酵母菌,在急性肠套叠手术复位后继发腹泻的预防方面,有部分疗效,可应用于临床。

Objective To observe the preventive effect of Saccharomyces boulardii on secondary diarrhea after surgical reduction for intussusception.Methods The children receiving only emergency operative reduction for intussusception were randomly divided into the observation group（given boulardii）（94 cases）and the control group（no boulardii）（88 cases）after operation..All of the patients were checked the stool occult blood and rotavirus antigen,and received other preoperative examinations.After operation conditions of the stool were paid attention to,and if diarrhea stool occult blood occurred,we immediately reexamined rotavirus antigen.Results In the observation group and the control group the incidence of secondary diarrhea was 6.3%（6/94）and 12.5%（11/88）respectively,the difference between the two groups having statistical significance（χ2=4.63,P=0.03）;postoperative time of diarrhea was（3.24±1.22）d and（4.63±1.14）d,the difference between the two groups having statistical significance（F=5.14,P=0.022）.All patients were cured and discharged.There was no recurrence of intussusception,wound infection,dehiscence,allergies or other conditions,and the discharge stools were normal.Conclusion Saccharomyces boulardii,in terms of the prevention of secondary diarrhea after surgical reduction for intussusception can be applied to treatment.