罗伊氏乳杆菌在早产儿早期喂养耐受及感染预防中的临床应用(附93例报告)

Effects of Lactobacillus reuteri on early feeding tolerance and infection prevention in preterm infants:A report of 93 cases

目的探讨罗伊氏乳杆菌DSM 17938在早产儿早期喂养耐受、生长发育及感染预防等方面发挥的作用。方法回顾性分析2017年1月至2018年6月中国医科大学附属盛京医院第一新生儿科病房收治的93例早产儿的临床资料。其中治疗组45例,对照组48例。两组早产儿均采用同种早产儿配方奶喂养及静脉营养,治疗组在开奶同时口服或经胃管给予剂量为1×108菌落形成单位(5滴)罗伊氏乳杆菌DSM 17938,每日1次,持续服用至出院,对照组不服用任何益生菌。观察两组早产儿喂养耐受、反流、生长发育、院内感染、新生儿坏死性小肠结肠炎以及不良反应发生情况。结果治疗组早产儿呕吐、腹胀、胃潴留发生率均低于对照组(P<0.05),每日反流次数明显低于对照组(P<0.001),最大喂养量较对照组显著提高(P<0.01);生长发育指标中,治疗组平均每日体重、头围增长均明显高于对照组,差异有统计学意义(P <0.01);两组早产儿院内感染及新生儿坏死性小肠结肠炎发生率相比较,组间差异均无统计学意义(P>0.05);治疗组住院时间短于对照组(P<0.05)。治疗组早产儿未见不良反应发生。结论罗伊氏乳杆菌DSM 17938可改善早产儿早期喂养耐受情况,减少胃食管反流,促进生长发育,同时缩短住院时间。

Objective To explore role of Lactobacillus reuteri DSM 17938 in the early feeding tolerance,growth and infection prevention of preterm infants.Methods The clinical data of 93 cases of preterm infants admitted between January 2017 and June 2018 to the First Department of Neonatology,Shengjing Hospital of China Medical University were analyzed retro spectively.All the cases were divided into the intervention group(n=45)and the control group(n=48).Both groups of preterm infants were fed with the same type of premature infant formula and received parenteral nutrition if necessary.The intervention group was given a dose of 1×108 colony-forming units(5 drops)of Lactobacillus reuteri DSM 17938 once a day,until discharge.The control group did not take any probiotics.The early feeding tolerance,reflux,growth,nosocomial infection,neonatal necrotizing enterocolitis and adverse effects were observed in both groups of preterm infants.Results The incidence of vomiting,abdominal distension and gastric retention in the intervention group was lower than that in the control group(P<0.05).The number of daily reflux in the intervention group was significantly lower than that in the control group(P<0.001)and the maximum feeding amount was significantly higher than that in the control group(P<0.01).Among the growth in dicators,the average daily weight gain and head circumference increase of intervention group were significantly higher than those of the control group(P<0.01).There was no significant difference in the incidence of nosocomial infection and necrotizing enterocolitis between the two groups(P>0.05).The length of hospital stay was shorter in intervention group than in the control group(P<0.05).No adverse effects were found in the intervention group.Conclusion Lactobacillus reuteri DSM 17938 can improve the early feeding tolerance of preterm infants,reduce reflux,promote growth and shorten the length of hospital stay.