双歧杆菌三联活菌散联合美罗培南治疗新生儿坏死性小肠结肠炎的效果

Effects of Bifidobacterium triple viable powder combined with Meropenem in treatment of neonatal necrotizing enterocolitis

目的:观察双歧杆菌三联活菌散联合美罗培南治疗新生儿坏死性小肠结肠炎(NEC)的效果。方法:选取2020年10月至2022年11月该院收治的116例NEC患儿进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各58例。对照组采用美罗培南治疗,研究组在对照组基础上联合双歧杆菌三联活菌散治疗,比较两组临床疗效、临床症状改善时间,治疗前后炎性因子[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-10(IL-10)]水平、肠道菌群分布指标水平,以及不良反应发生率。结果:研究组治疗总有效率为89.66%(52/58),高于对照组的75.86%(44/58),差异有统计学意义(P<0.05);研究组呕吐缓解时间、腹胀缓解时间、大便性状和次数恢复正常时间均短于对照组,差异有统计学意义(P<0.05);治疗后,两组CRP、PCT、IL-10水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组杆菌总数、球菌总数、球杆菌比值均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:双歧杆菌三联活菌散联合美罗培南治疗NEC可提高治疗总有效率,缩短临床症状改善时间,改善肠道菌群分布指标水平,降低炎性因子水平,其效果优于单纯美罗培南治疗。

Objective:To observe effects of Bifidobacterium triple viable powder combined with Meropenem in treatment of neonatal necrotizing enterocolitis(NEC).Methods:A prospective study was conducted on 116 children with NEC admitted to the hospital from October 2020 to November 2022.According to the random number table method,they were divided into study group and control group,58 cases in each group.The control group was treated with Meropenem,while the study group was treated with Bifidobacterium triple viable powder on the basis of that of the control group.The clinical efficacy,the improvement time of clinical symptoms,the levels of inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT)and interleukin-10(IL-10)],the levels of intestinalflora distribution indexes,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of the study group was 89.66%(52/58),which was higher than 75.86%(44/58)of the control group,and the difference was statistically significant(P<0.05).The vomiting relief time,the abdominal distension relief time,and the stool character and frequency recovery time in the study group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of CRP,PCT and IL-10 in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total number of bacilli,the total number of cocci and the ratio of bacilli to cocci in the two groups were higher than those before the treatment,and those in the study group were higher than the control group,the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Bifidobacterium triple viable powder combined with Meropenem in the treatment of the children with NEC can improve the total effective rate of treatment,shorten the improvement time of clinical symptoms,improve the levels of intestinalflora distribution indexes,and reduce the levels of inflammatory factors.Moreover,it is superior to single Meropenem treatment.