中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2012年
4期
405-407
,共3页
张应金%苏永棉%梁凤潇%李剑峰%张金凤%黄润忠
張應金%囌永棉%樑鳳瀟%李劍峰%張金鳳%黃潤忠
장응금%소영면%량봉소%리검봉%장금봉%황윤충
益生菌%呼吸机相关性肺炎%机械通气%细菌定植%胃-肺感染途径%双歧杆菌%婴儿,新生
益生菌%呼吸機相關性肺炎%機械通氣%細菌定植%胃-肺感染途徑%雙歧桿菌%嬰兒,新生
익생균%호흡궤상관성폐염%궤계통기%세균정식%위-폐감염도경%쌍기간균%영인,신생
Probiotics%Ventilator associated pneumonia%Mechanical ventilation%Bacteria colonization%Stomach to lung infection route%Bifidobacteria%Infant,newborn
目的 探讨阻断新生儿呼吸机相关性肺炎(ventilator associated pneumonia,VAP)胃-肺感染途径的方法,降低VAP发生率.方法 将机械通气的80例新生儿分为2组,治疗组(40例)鼻饲益生菌(双歧杆菌),对照组(40例)不干预.观察2组患儿VAP发生率、胃液pH值、胃细菌定植及其与VAP病原学的同源性.结果 治疗组和对照组患儿VAP发生率分别为12.5％ (5/40)和47.5％( 19/40),两组比较差异有统计学意义(x2=10.21,P＜0.01);治疗组患儿VAP发生时间[(5.4±2.1)d]明显晚于对照组[(4.3±1.0)d](t=3.2,P＜0.01).治疗组患儿予机械通气第7天胃液pH值≤3的比率(80.0％,32/40)明显高于对照组(47.5％,19/40)(x2=11.5,P＜0.01);而胃细菌定植率(30.0％,12/40)明显低于对照组(80.0％,32/40)(x2=16.9,P＜0.01);治疗组VAP病原菌与胃定植菌同源率(40.0％,2/5)明显低于对照组(78.9％,15/19)(x2=8.7,P＜0.01).结论 肠道益生菌能降低新生儿胃液pH值,抑制胃内细菌定植,延迟VAP发生时间,降低VAP发生率.
目的 探討阻斷新生兒呼吸機相關性肺炎(ventilator associated pneumonia,VAP)胃-肺感染途徑的方法,降低VAP髮生率.方法 將機械通氣的80例新生兒分為2組,治療組(40例)鼻飼益生菌(雙歧桿菌),對照組(40例)不榦預.觀察2組患兒VAP髮生率、胃液pH值、胃細菌定植及其與VAP病原學的同源性.結果 治療組和對照組患兒VAP髮生率分彆為12.5％ (5/40)和47.5％( 19/40),兩組比較差異有統計學意義(x2=10.21,P＜0.01);治療組患兒VAP髮生時間[(5.4±2.1)d]明顯晚于對照組[(4.3±1.0)d](t=3.2,P＜0.01).治療組患兒予機械通氣第7天胃液pH值≤3的比率(80.0％,32/40)明顯高于對照組(47.5％,19/40)(x2=11.5,P＜0.01);而胃細菌定植率(30.0％,12/40)明顯低于對照組(80.0％,32/40)(x2=16.9,P＜0.01);治療組VAP病原菌與胃定植菌同源率(40.0％,2/5)明顯低于對照組(78.9％,15/19)(x2=8.7,P＜0.01).結論 腸道益生菌能降低新生兒胃液pH值,抑製胃內細菌定植,延遲VAP髮生時間,降低VAP髮生率.
목적 탐토조단신생인호흡궤상관성폐염(ventilator associated pneumonia,VAP)위-폐감염도경적방법,강저VAP발생솔.방법 장궤계통기적80례신생인분위2조,치료조(40례)비사익생균(쌍기간균),대조조(40례)불간예.관찰2조환인VAP발생솔、위액pH치、위세균정식급기여VAP병원학적동원성.결과 치료조화대조조환인VAP발생솔분별위12.5％ (5/40)화47.5％( 19/40),량조비교차이유통계학의의(x2=10.21,P＜0.01);치료조환인VAP발생시간[(5.4±2.1)d]명현만우대조조[(4.3±1.0)d](t=3.2,P＜0.01).치료조환인여궤계통기제7천위액pH치≤3적비솔(80.0％,32/40)명현고우대조조(47.5％,19/40)(x2=11.5,P＜0.01);이위세균정식솔(30.0％,12/40)명현저우대조조(80.0％,32/40)(x2=16.9,P＜0.01);치료조VAP병원균여위정식균동원솔(40.0％,2/5)명현저우대조조(78.9％,15/19)(x2=8.7,P＜0.01).결론 장도익생균능강저신생인위액pH치,억제위내세균정식,연지VAP발생시간,강저VAP발생솔.
Objective To explore the method that can block the infection route from stomach to lung so as to reduce the incidence of ventilator-associated pneumonia (VAP) in neonates.Methods Neonates with mechanical ventilation were randomly divided into two groups,the treatment group(40 cases) were given probiotics (Bifidobacteria) by nasogastric feeding,control group(40 cases) were given nothing.Prospective survey was performed on the incidence of VAP,gastric juice pH,gastric bacterial colonization,the homology between gastric bacterial colonization and VAP pathogen.Results The VAP incidence of treatment group and control group was 12.5％ (5/40) and 47.5％ (19/40) respectively,there was significant difference between the two groups ( x2 =10.21,P ＜ 0.01 ).The onset time of VAP in treatment group [ ( 5.4 ±2.1 ) d] was later than that of control group[ (4.3 ± 1.0) d] ( t =3.2,P ＜0.01 ).The ratio of treatment group that gastric juice dropped to pH≤3 (80.0％,32/40) was higher than that of control group(47.5％,19/40) ( x2 =11.5,P ＜ 0.01 ) ; and the ratio of gastric bacterial colonization in treatment group ( 30.0％,12/40) was lower than that in control group(80.0％,32/40) ( x2 =16.9,P ＜0.01 ).The homology ratio between VAP pathogen and colonization bacteria in treatment group (40.0％,2/5 ) was lower than that in control group (78.9 ％,15/19 ) ( x2 =8.7,P ＜ 0.01 ).Conclusion Probiotics can reduce gastric juice pH of neonates and inhibit gastric bacterial colonization.The onset time of VAP can be delayed,the incidence of VAP can be reduced effectively.
