双歧杆菌对新生儿呼吸机相关性肺炎的预防效果

Preventive effect of bifidobacterium on ventilator-associated pneumonia in neonates

目的:探讨在新生儿呼吸机相关性肺炎(VAP)治疗中运用双歧杆菌的临床效果。方法:收治新生儿呼吸机相关性肺炎患者80例,平分两组。观察组给予双歧杆菌治疗,对照组不干预。对两组患者VAP发生率、胃液的p H值、胃细菌定植、患者和VAP病原学同源性进行对比。结果:观察组和对照组发生VAP的概率是12.5%、47.5%,差异有统计学意义(P<0.01)。观察组发生VAP时间是机械通气后第(5.30±2.06)天,比对照组的第(4.24±1.01)天多(P<0.01)。在第7天的时候,观察组在胃液p H≤3的比率82.31%,比对照组(46.52%)高,观察组胃细菌定植比率(32.52%),比对照组(72.19%)低(P<0.01)。观察组VAP病原菌和胃定植菌同源率40.02%,比对照组(75.01%)低(P<0.01)。运用双歧杆菌和胃液p H≤3是保护因素,患者胃内细菌定植为危险因素。结论:双歧杆菌的运用,有助于新生儿胃液p H值降低,使胃内细菌定植不断减少、VAP发生时间延迟,减少早发性VAP概率。

Objective:To investigate the clinical effect of bifidobacterium in neonatal ventilator-associated pneumonia(VAP).Methods:80 neonatal ventilator-associated pneumonia were selected.They were randomly divided into the two groups on average.The observation group was treated with bifidobacterium,and the control group was not given intervention.The incidence of VAP,p H value of gastric juice and gastric bacterial colonization were compared between groups of patients for etiological and VAP etiology.Results:The incidence of VAP in the observation group and the control group was 12.5% and 47.5%,and the difference was statistically significant(P<0.01).The time of VAP in the observation group was(5.30±2.06)days after mechanical ventilation,which was more than that of the control group(4.24±1.01)d(P<0.01).On the seventh day,the ratio of patients in observation group with p H≤3(82.31%)was higher than that in control group(46.52%),and the rate of gastric bacterial colonization in the observation group(32.52%)was lower than that in the control group(72.19%)(P<0.01).The homology rate of VAP pathogen and gastric colonization bacteria in observation group was 40.02%,which was lower than that of control group(75.01%)(P<0.01).The use of bifidobacteria and gastric juice p H≤3 are protective factors,gastric bacterial colonization is a risk factor.Conclusion:The use of bifidobacterium can reduce the p H value of neonatal gastric juice,reduce the bacterial colonization in the stomach,reduce the occurrence time of VAP,and reduce the incidence of early-onset VAP.