CAJ | 학술논문

目的：探讨微生态制剂对小儿血液肿瘤化疗后肠道菌群失调的影响。方法回顾性分析60例血液肿瘤患儿的临床病例资料，将患儿分根据治疗方法不同为观察组30例和对照组30例。对照组进行常规化疗方案治疗，观察组在化疗期间再给予口服双歧杆菌乳杆菌三联活菌片（金双歧），化疗当天服用，每次2片，每天3次，4周为1个疗程，化疗前后进行肠道菌群检测（肠杆菌、肠球菌、双歧杆菌、乳酸杆菌、大肠埃希菌），记录化疗后呼吸、泌尿、消化、皮肤系统感染发生情况。结果观察组治疗后双歧杆菌、乳杆菌较治疗前明显增多（t ＝3.947、3．636，均 P ＜0．05），肠杆菌、肠球菌、大肠埃希菌治疗前后差异均无统计学意义（均 P ＞0．05），对照组治疗后肠杆菌、肠球菌、双歧杆菌、乳酸杆菌、大肠埃希菌均较治疗前明显降低（t ＝3．712、3.641、3．722、3.543、3．616，均 P ＜0．05），观察组治疗后肠杆菌、肠球菌、双歧杆菌、乳酸杆菌、大肠埃希菌明显高于对照组（t ＝3．327、3．641、6．378、7．367、3．364，均 P ＜0．05）；观察组出现呼吸道感染、胆囊炎、肠炎、泌尿系统感染的发生率分别为50．00％、6．67％、16．67％、23．33％，明显低于对照组的93．33％、30．00％、63.33％、60．00％（χ2＝13．871、5．455、13．611、8．297，均 P ＜0．05）。结论小儿血液肿瘤化疗后可能造成肠道菌群失调，是引起化疗后各种感染的重要原因，微生态制剂能够重建肠道生态平衡，提高肠道益生菌数量，扶植正常菌群生长，调整肠道菌群失调，降低感染发生概率，利于化疗顺利完成，值得临床推广应用。
목적：탐토미생태제제대소인혈액종류화료후장도균군실조적영향。방법회고성분석60례혈액종류환인적림상병례자료，장환인분근거치료방법불동위관찰조30례화대조조30례。대조조진행상규화료방안치료，관찰조재화료기간재급여구복쌍기간균유간균삼련활균편（금쌍기），화료당천복용，매차2편，매천3차，4주위1개료정，화료전후진행장도균군검측（장간균、장구균、쌍기간균、유산간균、대장애희균），기록화료후호흡、비뇨、소화、피부계통감염발생정황。결과관찰조치료후쌍기간균、유간균교치료전명현증다（t ＝3.947、3．636，균 P ＜0．05），장간균、장구균、대장애희균치료전후차이균무통계학의의（균 P ＞0．05），대조조치료후장간균、장구균、쌍기간균、유산간균、대장애희균균교치료전명현강저（t ＝3．712、3.641、3．722、3.543、3．616，균 P ＜0．05），관찰조치료후장간균、장구균、쌍기간균、유산간균、대장애희균명현고우대조조（t ＝3．327、3．641、6．378、7．367、3．364，균 P ＜0．05）；관찰조출현호흡도감염、담낭염、장염、비뇨계통감염적발생솔분별위50．00％、6．67％、16．67％、23．33％，명현저우대조조적93．33％、30．00％、63.33％、60．00％（χ2＝13．871、5．455、13．611、8．297，균 P ＜0．05）。결론소인혈액종류화료후가능조성장도균군실조，시인기화료후각충감염적중요원인，미생태제제능구중건장도생태평형，제고장도익생균수량，부식정상균군생장，조정장도균군실조，강저감염발생개솔，리우화료순리완성，치득림상추엄응용。
Objective To investigate the effect of micro ecological preparation on imbalance of intestinal flora in pediatric blood cancer after chemotherapy.Methods The clinical data of 60 patients with blood cancer were retrospectively analyzed.All patients were divided into the observation group and control group by different trentment methods,30 cases in each group.The control group were received conventional chemotherapy,the observation group were given Lactobacillus triple viable Bifidobacterium piece(two piece once,tid,4 weeks for a course)on the basis of the control group,the intestinal flora(Enterobacteriaceae,Enterococcus,Bifidobacterium,Lactobacillus,Escherichia coli)were detected before and after chemotherapy,made a record of respiratory,urinary,digestive,skin infections after chemotherapy.Results The Bifidobacterium and Lactobacillus of the observation group after treatment were signifi-cantly higher than before treatment(t =3.947,3.636,all P <0.05),there were no difference in Enterobacter,Entero-coccus,Escherichia coli in the observation group before and after treatment(all P >0.05).The Enterobacter,Entero-coccus,Bifidobacterium,Lactobacillus,Escherichia coli of the control group were lower after treatment than before treatment(t =3.712,3.641,3.722,3.543,3.616,all P <0.05),the Enterobacter,Enterococcus,Bifidobacterium, Lactobacillus,Escherichia coli of the observation group after treatment were higher than that of the control group(t =3.327,3.641,6.378,7.367,3.364,all P <0.05).The respiratory tract infection,cholecystitis,colitis,urinary tract infections incidence of the observation group were 50.00%,6.67%,16.67%,23.33%,respectively,which were low-er than 93.33%,30.00%,63.33%,60.00% of the control group(χ2 =13.871,5.455,13.611,8.297,all P <0.05).Conclusion The intestinal flora may be caused for treatment of chemotherapy,which are the importmant rea-son of various infections after chemotherapy,the Probiotics can reconstruct the ecological balance of the gut,increase the number of probiotics,foster the growth of normal flora,adjust the intestinal flora,reduce the chance of infection, conducive to the successful completion of chemotherapy,which is worthy of clinical application.