【摘要】 目的观察双歧杆菌对机械通气新生儿呼吸道和胃肠道的影响。方法将机械通气新生儿随机分为观察组(n=38)和对照组(n=43),观察组在机械通气后第2天开始鼻饲双歧杆菌1粒/d,连用7 d,对照组不予干预。观察两组胃液pH、胃定植菌、喂养不耐受、体重增加、呼吸机相关性肺炎(VAP)发生比率及病原菌与胃定植菌同源性等情况。结果观察组第3、5天及第7天胃液pH≤3的比例均明显高于对照组(P<0.01),而第5天及第7天胃细菌定植率均明显低于对照组(P<0.01)。观察组喂养不耐受和VAP发生比例均低于对照组(P<0.05,P<0.01),同时观察组VAP病原菌与胃定植菌同源率显著低于对照组(P<0.01)。两组体重日增加量差异无统计学意义(P>0.05)。结论双歧杆菌可降低胃酸度,减少胃定植菌和喂养不耐受发生,可间接阻断胃-口咽-呼吸道感染途径,从而减少VAP的发生。更多还原

【Abstract】 Objective To study the effects of bifidobacterium on respiratory and gastrointestinal tracts in neonates receiving mechanical ventilation. Methods The eligible neonates were randomly assigned into two groups: observed(n=38) and control(n=43).The observed group was given bifidobacteria daily(one capsule per time,for 7 days) by nasal feeding from the next day after mechanical ventilation.Gastric pH,gastric bacteria colonization,feeding intolerance,weight gain,the incidence of ventilator-associated pneumonia(VAP),and the homology between the bacteria isolated from intra-gastric colonization with those causing VAP were observed. Results The incidence of gastric pH≤3 in the observed group was significantly higher than that in the control group 3,5 and 7 days after mechanical ventilation(P<0.01).The rate of gastric bacteria colonization in the observed group was significantly lower than that in the control group 5 and 7 days after mechanical ventilation(P<0.01).The incidences of feeding intolerance and VAP in the observed group were significantly lower than those in the control group(P<0.05,P<0.01,respectively).The rate of homology of the bacteria isolated from intra-gastric colonization with those causing VAP in the observed group was significantly lower than that in the control group(P<0.01).There were no significant differences in the weight gain between the two groups. Conclusions Bifidobacterium can decrease gastric pH,gastric bacteria colonization and feeding intolerance,thus blocks the infection route "stomach-oropharynx-respiratory tract" indirectly and decreases the incidence of endogenous VAP in neonates receiving mechanical ventilation.更多还原