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【摘要】目的:探讨微生态制剂预防小儿肺炎继发腹泻的疗效。方法:选取儿科住院治疗的小儿肺炎患儿480例,随机分组3组:对照组176例给予抗生素等对症支持治疗。预防AC腹泻发生率预防A组为16.47%,预防B组为17.61%,对照组为37.50%。A、B预防组与对照组比较差异有统计学意义(P≮0.05)。结论:预防性应用微生态制剂,能有效降低小儿肺炎继发腹泻的发生率,尤其是1~12个月年龄阶段的小儿,且安全可靠,无不良反应,值得临床推广。�
【关键词】小儿肺炎;腹泻;微生态制剂�
doi:10.3969/j.issn.1006-1959.2010.08.011文章编号:1006-1959(2010)-08-1987-02�
Analyze The Curative Effect Of Micro Eecological Praeparatum In Treament Of Beforehand Children Pneumonic Secondary DiarrheaZHANG Lin-hongPharmacy department of Maternal and Child Health Hospital, Chongzhou district�
【Abstract】Objective:It is to approach the curative effect of micro ecological praeparatum preventing beforehand children pneumonic secondary diarrhea.Menthods:480 pneumonia children who were hospitalized were chosed and divided into three groups。176 cases were in control group and treated with antibiotics only 。176 cases were in A prevention group and treated with antibiotics in duration of hospital stay at the same time applying micro ecological praeparatum(Gloden Bifid)。176 cases were in B prevention group and treated with antibiotics in duration of hospital stay at the same time applying micro ecological praeparatum(Medilac Vita).Results :The incidence rate of secondary diarrhea in A prevention group was16.47%. The incidence rate of secondary diarrhea in B prevention group was17.61%. The incidence rate of secondary diarrhea in control group was37.50%.Simple factor test showed that the incidence rate of secondary diarrhea in A 、B prevention groups were both lower than that in control group.Conclusion preventive use micro ecological praeparatum can lower the incidence rate of children pneumonic secondary diarrhea .especially at beforehand children of 1-12 months of age and it is have no side effect. While it is safe and effect. It is to be useful for clinical expansion �
【Key words】 Beforehand children pneumonia; Diarrhea;Micro ecological praeparatum
肺炎是因为各种原因导致的感染累及患儿肺部所引发的炎症病变,临床较为常见。流行病学资料显示肺炎患儿占住院儿童的30%-50%,而其中小儿肺炎继发腹泻的发生率高达25.0%~52.9%��[1]�。肺炎继发腹泻与治疗肺炎是所选用的抗生素抗菌谱、治疗时间、患儿个体差异等因素密切相关。小儿肺炎继发腹泻的时间可以在肺炎出现的同时、治疗过程中、好转后等不同时间并导致患儿病情加重,住院时间延长。我院儿科应用微生态制剂(金双歧片和妈咪爱散剂)预防小儿肺炎继发腹泻的发生,疗效显著,值得临床推广。现将临床观察报道如下。�
1.资料与方法�
1.1一般资料:本组480例患儿均为2009年3月至2010年3月在我院儿科住院治疗的肺炎患者。均符合小儿肺炎诊断标准��[2]�。入院和入院后72 h内发生腹泻的患儿不及在内。其中男236例,女244例;年龄1个月~9岁。将所有患儿随机分为:预防A组176例,男89例,女87例;B组176例,男87例,女89例;对照组128例,男60例,女68例。三组患儿年龄、性别等一般资料比较差异无统计学意义(P>0.05),具有可比性。�
1.2治疗方法:确诊后均按正常治疗方案应用抗生素、抗病毒药及止咳化痰、解痉平喘等对症治疗。抗生素抗生素均应用青霉素静脉滴注,剂量:10万IU/(kg・d),头孢噻肟静脉点滴,剂量:100 mg/(kg・d),每日两次。�
1.2.1预防A组在使用抗生素治疗同时加用金双歧片(双奇药业股份有限公司生产,5g*24片)口服,6个月内婴儿一次1片,一日3次;6个月至3岁小儿一次2片,一日3次;3岁至9岁小儿一次3片,一日3次。用温开水(〈40度)或温牛奶冲服,婴幼儿可将药片碾碎后溶于温牛奶冲服。与抗生素间隔2h,嘱其药片冷藏(2-8℃)放置。�
1.2.2预防B组在使用抗生素治疗的同时加用妈咪爱散剂((北京韩美公司生产,1g/袋,含1.5 x 100个活菌),小于2岁者每次一袋,每日2次;2岁以上者每次2袋,每日2次。与抗生素间隔2 h应用。预防组出现继发腹泻后仍继续给予微生态制剂治疗。�
1.2.3对照组出现继发腹泻后在原有基础上加用微生态制剂。�
1.3评定标准:�
1.3.1小儿肺炎继发腹泻的诊断标准��[3]�。临床确诊为肺炎,患者住院72h后出现大便性状改变,排便次数增多至每日3次以上。可分为轻型腹泻:患者具有腹泻症状,但无脱水、酸中毒、电解质絮乱;重型腹泻:患者腹泻伴有无脱水、酸中毒、电解质絮乱��[4]�。�
1.3.2疗效判断标准。本研究治疗效果判定根据1998年全国腹泻病防治学术研讨会组织委员会制定的标准��[4]�进行。显效:治疗72 h内患者大便性状及次数完全恢复,患者病例症状和体征全部消失;有效:治疗72 h内患者大便性状有明显改善,大便次数比治疗前明显减少,患者全身症状有比较大的改善;无效:治疗72h患者粪便性状及次数无变化或者恶化、患者全身症状无改善或者恶化。�
1.4统计学处理。采用SPSS13.0软件对所得数据进行统计学分析,计量资料医均数±标准差表示,组间比较采用t检验;计数资料以报分率表示,率化以后显著性比较采x��2�检验,以P
