益生菌防治出生低体质量儿肠道外营养相关性胆汁淤积的临床研究
|
摘要
目的:探讨益生菌防治出生低体质量儿肠道外营养相关性胆汁淤积的临床效果。方法:收集2012年3月—2017年3月本院收治的62例出生低体质量患儿为研究对象,采用随机数字表法分为对照组和观察组,各31例,对照组给予常规药物治疗,观察组给予益生菌防治,比较两组治疗前后实验室检测指标[总胆汁酸(TBA)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)]变化、胃肠功能、生理性体质量下降幅度、出现胆汁淤积时间、胆汁淤积综合征发生率。结果:治疗后观察组达全肠喂养时间明显短于对照组,喂养不耐受发生率、生理性体质量下降幅度明显低于对照组,差异有统计学意义(P <0.05);治疗后两组TBA、TBIL、ALT较治疗前明显降低,且观察组明显低于对照组,差异有统计学意义(P <0.05);治疗后观察组出现胆汁淤积时间明显长于对照组,胆汁淤积综合征发生率明显低于对照组,差异有统计学意义(P <0.05)。结论:益生菌防治出生低体质量儿肠道外营养相关性胆汁淤积的临床效果明确,可有效改善患儿胃肠功能和胆汁淤积情况,与有效调节TBA、TBIL、ALT水平有一定关联,且安全性好。
Objective: To investigate the clinical effect of probiotics in the prevention and treatment of parenteral nutrition-related cholestasis in low birth weight infants. Methods: 62 children with low birth weight admitted to our hospital from March 2012 to March 2017 were enrolled as subjects investigated and randomly divided into a control group and an observation group, 31 cases each. The children in the control group were given conventional drug treatment, and the children in the observation group were given probiotics for prevention and treatment. The changes in laboratory test indexes [total bile acid(TBA), total bilirubin(TBIL), alanine aminotransferase(ALT)] before and after treatment, gastrointestinal functions, decline degree in physiological body mass, the occurrence time of cholestasis and the incidence of cholestasis syndrome were compared between the two groups. Results: After treatment, the time of reaching total intestinal feeding in the observation group was significantly shorter than that in the control group, and the incidence of feeding intolerance and the decline degree in physiological body weight were significantly lower than those in the control group, with statistically significant differences(P<0.05). The levels of TBA, TBIL and ALT in the two groups after treatment were significantly lower than those before treatment, and the levels in the observation group were significantly lower than those in the control group, with statistically significant differences(P<0.05). After treatment, the occurrence time of cholestasis in the observation group was significantly longer than that in the control group, and the incidence of cholestasis syndrome was significantly lower than that in the control group, with statistically significant differences(P<0.05). Conclusion:Probiotics have a definite clinical effect in preventing and treating parenteral nutrition-related cholestasis in low birth weight infants, and can effectively improve gastrointestinal functions and cholestasis of the children, which is correlated with the effective regulation of TBA, TBIL and ALT levels, and have good safety.
Objective: To investigate the clinical effect of probiotics in the prevention and treatment of parenteral nutrition-related cholestasis in low birth weight infants. Methods: 62 children with low birth weight admitted to our hospital from March 2012 to March 2017 were enrolled as subjects investigated and randomly divided into a control group and an observation group, 31 cases each. The children in the control group were given conventional drug treatment, and the children in the observation group were given probiotics for prevention and treatment. The changes in laboratory test indexes [total bile acid(TBA), total bilirubin(TBIL), alanine aminotransferase(ALT)] before and after treatment, gastrointestinal functions, decline degree in physiological body mass, the occurrence time of cholestasis and the incidence of cholestasis syndrome were compared between the two groups. Results: After treatment, the time of reaching total intestinal feeding in the observation group was significantly shorter than that in the control group, and the incidence of feeding intolerance and the decline degree in physiological body weight were significantly lower than those in the control group, with statistically significant differences(P<0.05). The levels of TBA, TBIL and ALT in the two groups after treatment were significantly lower than those before treatment, and the levels in the observation group were significantly lower than those in the control group, with statistically significant differences(P<0.05). After treatment, the occurrence time of cholestasis in the observation group was significantly longer than that in the control group, and the incidence of cholestasis syndrome was significantly lower than that in the control group, with statistically significant differences(P<0.05). Conclusion:Probiotics have a definite clinical effect in preventing and treating parenteral nutrition-related cholestasis in low birth weight infants, and can effectively improve gastrointestinal functions and cholestasis of the children, which is correlated with the effective regulation of TBA, TBIL and ALT levels, and have good safety.
引文
[1]丁国芳.极低出生体重儿尽早达到足量肠内营养喂养策略-《极低出生体重儿喂养指南》解读[J].中国实用儿科杂志,2016,31(2):85-89.
[2]刘云凤,邹朝春.熊去氧胆酸治疗早产儿胃肠外营养相关性胆汁淤积症的疗效及对患儿血清内毒素水平的影响[J].中国医院药学杂志,2017,37(5):459-461.
[3]邓金金.极低出生体重儿营养与支持治疗50例临床分析[J].广东医学,2016,37(s1):73-74.
[4]刘芳,陈宇辉,卫海燕,等.极低出生体重儿营养支持治疗中小剂量胰岛素持续静脉泵注临床观察[J].山东医药,2016,56(7):69-70.
[5]姚希,徐丹慧,贾建侠,等.2011-2016年耐碳青霉烯肺炎克雷伯菌医院感染趋势分析[J].中华医院感染学杂志,2017,27(12):2652-2655.
[6]葛星,徐叶清,黄三唤,等.妊娠期肝内胆汁淤积症对分娩结局影响的出生队列研究[J].中华流行病学杂志,2016,37(2):187-191.
[7]严晶晶,夏晓萍,部娜.茵栀黄口服液辅助治疗妊娠肝内胆汁淤积症的Meta分析[J].中国中药杂志,2016,41(23):4428-4435.
[8]郭珊,舒赛男.益生菌在儿童肝胆疾病的应用[J].中国实用儿科杂志,2017,32(2):110-114.
[9]边静,杨云成.益生菌防治极低和低出生体重早产儿喂养不耐受的临床价值[J].海南医学,2016,27(20):3401-3403.
[10]黎红平,马丽亚,肖斌,等.益生菌对极低出生体重早产儿生后第14天肠道菌群的影响[J].中华新生儿科杂志,2017,32(4):264-268.
[11]张曼,金鑫,田巧珍,等.益生菌对肠道先天防御反应调节作用的研究进展[J].中国畜牧兽医,2017,44(12):3656-3662.
[12]郭城,张琳.益生菌在新生儿坏死性小肠结肠炎中的应用[J].中国实用儿科杂志,2017,32(2):120-125.
[13]梁惠,吕锐,傅泳,等.益生菌对大鼠酒精性肝损伤的保护作用及机制研究[J].中国药理学通报,2016,32(7):991-997.
[14]梁伟时,康佳丽,孟徐兵,等.肠道菌群失调与2型糖尿病并发症关系的研究进展[J].山东医药,2017,57(29):107-109.
[2]刘云凤,邹朝春.熊去氧胆酸治疗早产儿胃肠外营养相关性胆汁淤积症的疗效及对患儿血清内毒素水平的影响[J].中国医院药学杂志,2017,37(5):459-461.
[3]邓金金.极低出生体重儿营养与支持治疗50例临床分析[J].广东医学,2016,37(s1):73-74.
[4]刘芳,陈宇辉,卫海燕,等.极低出生体重儿营养支持治疗中小剂量胰岛素持续静脉泵注临床观察[J].山东医药,2016,56(7):69-70.
[5]姚希,徐丹慧,贾建侠,等.2011-2016年耐碳青霉烯肺炎克雷伯菌医院感染趋势分析[J].中华医院感染学杂志,2017,27(12):2652-2655.
[6]葛星,徐叶清,黄三唤,等.妊娠期肝内胆汁淤积症对分娩结局影响的出生队列研究[J].中华流行病学杂志,2016,37(2):187-191.
[7]严晶晶,夏晓萍,部娜.茵栀黄口服液辅助治疗妊娠肝内胆汁淤积症的Meta分析[J].中国中药杂志,2016,41(23):4428-4435.
[8]郭珊,舒赛男.益生菌在儿童肝胆疾病的应用[J].中国实用儿科杂志,2017,32(2):110-114.
[9]边静,杨云成.益生菌防治极低和低出生体重早产儿喂养不耐受的临床价值[J].海南医学,2016,27(20):3401-3403.
[10]黎红平,马丽亚,肖斌,等.益生菌对极低出生体重早产儿生后第14天肠道菌群的影响[J].中华新生儿科杂志,2017,32(4):264-268.
[11]张曼,金鑫,田巧珍,等.益生菌对肠道先天防御反应调节作用的研究进展[J].中国畜牧兽医,2017,44(12):3656-3662.
[12]郭城,张琳.益生菌在新生儿坏死性小肠结肠炎中的应用[J].中国实用儿科杂志,2017,32(2):120-125.
[13]梁惠,吕锐,傅泳,等.益生菌对大鼠酒精性肝损伤的保护作用及机制研究[J].中国药理学通报,2016,32(7):991-997.
[14]梁伟时,康佳丽,孟徐兵,等.肠道菌群失调与2型糖尿病并发症关系的研究进展[J].山东医药,2017,57(29):107-109.