摘要目的 研究布拉酵母菌散剂对极低出生体质量儿的临床意义.方法 198例极低出生体质量儿中未服布拉酵母菌散剂早产儿93例(对照组),口服布拉酵母菌散剂早产儿105例(观察组),回顾性对照分析两组患儿的一般资料,观察两组患儿大便频次或腹泻(伴中重度脱水)情况、新生儿坏死性小肠结肠炎(NEC)发生率、院内感染(败血症、肺部感染)发生率、真菌感染率、静脉营养时间、总住院时间.结果 两组患儿一般资料比较差异无统计学意义(P＞0.05).观察组和对照组患儿大便频次、静脉营养时间、住院时间比较差异有统计学意义[(1.8±0.4)次/d比(3.4±0.5)次/d、(30.21 ±3.43)d比(40.47±4.35)d、(33.5±6.8)d比(45.4±9.3)d](P＜0.05);两组新生儿腹泻、NEC、败血症或脓毒血症发生率比较差异有统计学意义[14.3％(15/105)比25.8％(24/93)、11.4％(12/105)比19.4％(18/93)、19.0％(20/105)比29.0％(27/93)] (P＜ 0.05);两组肺炎发生率和真菌感染率比较差异无统计学意义(P＞0.05).结论 口服布拉酵母菌散剂可以减少极低出生体质量儿腹泻发生率,减少NEC发生率,以及院内感染发生率(主要是败血症),可以促进胃肠喂养,缩短住院时间,同时亦不会增加真菌感染率,有临床应用价值.

abstractsObjective To evaluate the effect of Saccharomyces boulardii (SB) administration on very-low-birth-weight (VLBW) infants.Methods One hundred and ninety-eight preterm infants were prospectively randomized into observation group (105 cases) and control group (93 cases) based on the symptomatic and supportive treatment.When uncompletely stomach intestine nutrition fed,the patients of observation group took SB (50 mg/kg),the patients of control group took equivalent placebo.The times of defecation and diarrhea,the rate of neonatal necrotizing enterocolitis,hospital onset of infection (septicemia,pulmonary infection),fungal infection,the time of intravenous nutrition and length of stay were compared.Results The general data in two groups had no significant difference (P ＞ 0.05).The times of defecation,time of intravenous nutrition and length of stay in two groups had significant difference [(1.8 ± 0.4) times/d vs.(3.4 ± 0.5) times/d,(30.21 ± 3.43) d vs.(40.47 ± 4.35) d,(33.5 ± 6.8) d vs.(45.4 ± 9.3) d] (P ＜ 0.05).The rate of diarrhea,neonatal necrotizing enterocolitis,septicemia and pyemia in two groups had significant difference [14.3％ (15/105) vs.25.8％ (24/93),11.4％ (12/105) vs.19.4％ (18/93),19.0％ (20/105) vs.29.0％ (27/93)] (P ＜ 0.05).The rate of pulmonary infection and fungal infection between two groups had no significant difference(P＞ 0.05).Conclusion SB administration on VLBW infants can reduce the infection,promote enteral feeding,shorter hospital stay,and has a certain significance on the family and the community.