小肠细菌过度生长在婴幼儿腹泻中的临床分析

Clinical analysis of small intestinal bacteria overgrowth in infancy diarrhea

目的研究小肠细菌过度生长(SIBO)在婴幼儿迁延性和慢性腹泻中的患病率,同时分析婴幼儿SIBO的临床特点及治疗转归。方法回顾性研究2017年4月11日至2019年4月10日我院住院部消化内科收治的迁延性和慢性腹泻婴幼儿110例。应用乳糖氢呼气试验作为SIBO的诊断方法。结果乳糖氢呼气试验阳性率为9.09%(10例);SIBO阳性患儿与SIBO阴性患儿比较,阳性患儿黏液便少于阴性患儿,差异有统计学意义(P<0.05);大便次数、腹胀、呕吐、哭闹情况、脱水比较差异无统计学意义(P>0.05);阳性患儿贫血发生率、生长迟缓率、乳糖吸收不良发生率均高于阴性患儿,差异有统计学意义(P<0.05);阳性患儿给予益生菌治疗及去乳糖奶粉喂养后,出院时8例症状缓解,1例无明显缓解。结论SIBO在婴幼儿腹泻中较常见,临床表现无显著特异性,易出现水样便、贫血、生长迟缓、乳糖吸收不良,益生菌治疗及饮食调整有效。

Objective To study the prevalence of small intestinal bacterial overgrowth(SIBO)in infants with persistent and chronic diarrhea,and to analyze the clinical features and treatment outcomes of SIBO in infants.Methods A retrospective study was made in 110 infants with persistent and chronic diarrhea,who were treated in the Department of Gastroenterology of our hospital from April 11,2017 to April 10,2019.The lactose hydrogen breath test was used as a diagnostic method for SIBO.Results The positive rate of lactose hydrogen breath test was 9.09%(10/110).Comparing the SIBO positive group with SIBO negative group,the mucous stool in positive group was less than that in SIBO negative group,and the difference was statistically significant(P<0.05).There was no significant difference in frequency of bowel movement,abdominal distension,vomiting,crying or dehydration(P>0.05).The incidence of anemia,growth retardation and lactose malabsorption in the positive group were all higher than those in the negative group,and the difference was statistically significant(P<0.05).After being treated with probiotics and fed with lactose-free milk powder,the symptoms of 8 cases(8/9)were relieved on discharge,while 1 case(1/9)was not significantly relieved.Conclusion SIBO is more common in infancy diarrhea,and its clinical manifestations are not significantly specific.The infants are more likely to have watery stool,anemia,growth retardation and lactose malabsorption.Probiotics and diet adjustment are effective.