布拉酵母菌预防新生儿抗生素相关性腹泻临床观察

Saccharomyces Boulardii in the Prevention of Antibiotics-Associated Diarrhea in Neonates

目的:探讨布拉酵母菌预防新生儿抗生素相关性腹泻(AAD)的疗效及安全性。方法:选取2017年8月至2018年8月在宿州市立医院新生儿病房使用抗生素治疗的新生儿298例,随机分为干预组和对照组。干预组除静脉使用抗生素外,给予布拉酵母菌散剂口服,每次0.125 g,2次/日,共14 d,对照组仅给予常规抗感染治疗。观察治疗期间两组患儿AAD发生率及相关指标变化情况,记录AAD患儿排便次数和持续时间,并根据不同日龄患儿AAD发生率评价预防效果。结果:抗生素使用期间,干预组AAD发生率(11.49%)较对照组(29.33%)降低(P<0.01)。干预组应用抗生素时间和住院时间均较对照组缩短(P均<0.01)。干预组AAD患儿在治疗第l、4、7天平均排便次数及持续腹泻时间均较对照组减少(P均<0.01)。干预组≤7 d患儿AAD患病风险降低了47%(P<0.05),干预组>7 d患儿降低了78%(P<0.05);停用抗生素后14 d内,≤7 d患儿中,干预组AAD患病风险降低了68%(P<0.05),>7 d患儿中,干预组降低了92%(P<0.05)。结论:布拉酵母菌可降低新生儿AAD发生率,减轻AAD症状,其具有延迟保护效应,可有效且安全地预防新生儿AAD。

Objective:To probe into the efficacy and safety of Saccharomyces boulardii in the prevention of antibiotics-associated diarrhea(AAD)in neonates.Methods:A total of 298 neonates treated with antibiotics in the neonatal ward of Suzhou Municipal Hospital of Anhui Province from Aug.2017 to Aug.2018 were extracted to be divided into the intervention group and the control group.In addition to intravenous antibiotics,the intervention group was given oral S.boulardii powder,0.125 g each time,twice a day,for a total of 14 d.The control group only received conventional anti-infection therapy.The incidence of AAD and changes of related indicators in both groups were observed during treatment,the frequency and duration of defecation in children with AAD were recorded.The prevention effect was evaluated according to the incidence of AAD in children of different ages.Results:During antibiotic administration,the incidence of AAD in the intervention group(11.49%)was lower than that in the control group(29.33%,P<0.01).The application time of antibiotics and length of stay in the intervention group were shorter than those in the control group(P<0.01).The average frequency of defecation and duration of diarrhea decreased in children with AAD in the intervention group compared with those in the control group on the 1st,4th and 7th d of treatment(P<0.01).The risk of AAD in children≤7 d in the intervention group was reduced by 47%(P<0.05),and the risk of children>7 d in the intervention group was reduced by 78%(P<0.05).Within 14 d after the withdrawal of antibiotics,the risk of AAD in children≤7 d in the intervention group was reduced by 68%(P<0.05),and the risk of AAD in children>7 d in the intervention group was reduced by 92%(P<0.05).Conclusion:S.boulardii can reduce the incidence of AAD and alleviate the symptoms in neonates,and its delayed protective effect is effective and safe in preventing AAD.