抗菌药物对感染性肺炎新生儿的疗效及肠道微生态的影响分析

Effect of antibiotics efficacy of neonatal infectious pneumonia and intestinal microflora analysis

目的研究用不同抗菌药物治疗新生儿感染性肺炎的临床效果,以及对肠道微生态的影响,为临床治疗提供理论依据。方法选择2014年9月-2015年9月间诊治180例无并发症的感染性肺炎新生儿,根据应用药物不同将其分为3组,60例为头孢组,58例为青霉素组,62例为联合用药组,比较各组患儿的临床治愈率及治愈时间,同时选择80例健康新生儿作为对照组,观察各组肠道微生态环境。结果患儿治愈率头孢组为73.3%,青霉素组为72.4%,联合用药组为74.2%,3组治愈率差异无统计学意义;临床治愈时间头孢组患儿为(5.4±0.3)d,青霉素组为(5.6±0.3)d,联合用药组为(5.3±0.4)d,3组治愈时间差异无统计学意义;用药组患儿的双歧杆菌数量明显比对照组低,差异有统计学意义(P<0.05);用药组患儿的肠杆菌、消化链球菌以及肠球菌数量明显比对照组多,差异有统计学意义(P<0.05),类杆菌数量未见明显差异。结论感染性肺炎新生儿应用抗菌药物治疗时更偏向联合用药,但是联合用药会对新生儿的肠道微生态产生破坏,打破正常平衡状态,因而临床上应合理应用抗菌药物。

OBJECTIVE To study the clinical effects to neonatal infectious pneumonia using different antibiotics and the impact to intestinal microflora, in order to provide a theoretical basis for clinical treatment. METHODS A total of 180 newborns with infectious pneumonia from our hospital between Sep. 2014 to Sep. 2015 were chosen, who were divided into three groups, according to the application of different drugs, 60 cases with cephalosporin group, 58 cases penicillin group and 62 patients combined treatment group, and the clinical cure rate and cure time for each group of children were compared. While 80 healthy patients were chosen as a control group, and the gut mi- croflora environment in each group were observed. RESULTS The cure rate in patients in cephalosporin group was 73.3%, penicillin group 72.4%, the combined treatment group 74.2%, no significant difference in the cure rate of the three groups. Cephalosporin group of patients with clinical cure time was （5.4±0.3） d, penicillin group （5.6±0.3） d, combination therapy group （5.3±0.4） d, the three groups showed no difference in healing time. Treatment group were significantly lower than the number of Bifidobacteria ~ the control group, and the differ- ence was significant （P〈0.05）. The number of Enterobacteriaceae, Peptostreptococcus and Enterococci in pa- tients with drugs were significantly higher than the control group （P〈0.05）. Bacteroides number had no signifi- cant difference. CONCLUSION The treatment in combination was preferred in neonatal pneumonia antibiotics treatment, but the combination treatment will cause damage to intestinal microflora newborns and break the nor- mal state of equilibrium, therefore antimicrobial drugs should be rational used in clinic.