目的 研究硫酸鋅聯(lián)合布拉酵母菌預(yù)防兒童抗生素相關(guān)性腹瀉的臨床療效。方法 選取2012年3月-2015年8月廊坊市第四人民醫(yī)院兒科收治的120例支氣管肺炎患兒，隨機(jī)分為對照組和治療組，每組各60例。入院后所有患兒進(jìn)行對癥以及抗感染治療。對照組患兒在抗生素治療的第一天開始口服布拉酵母菌散，1~3歲，0.25 g/次，1次/d；年齡>3歲，0.25 g/次，2次/d。治療組患兒在對照組治療基礎(chǔ)上口服硫酸鋅顆粒，1~5 g/次，3次/d。兩組均連續(xù)治療3 d。在治療過程中如果有腹瀉發(fā)生，立即使用蒙脫石散，并進(jìn)行補(bǔ)液治療。觀察兩組抗生素相關(guān)性腹瀉的發(fā)生時間、發(fā)生率并對腹瀉程度進(jìn)行分級。觀察兩組的臨床療效，記錄兩組患兒的大便次數(shù)、大便次數(shù)恢復(fù)時間、大便性狀恢復(fù)時間及腹瀉總療程。結(jié)果 治療過程中，對照組和治療組抗生素相關(guān)性腹瀉的發(fā)生率分別為43.33%、26.67%，治療組輕度、中度腹瀉患者少于對照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療組腹瀉發(fā)生時間明顯晚于對照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。對照組和治療組的總有效率分別為61.54%、81.25%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療第1天時，兩組患兒的大便次數(shù)比較無統(tǒng)計(jì)學(xué)意義；第3、5天時，兩組患兒大便次數(shù)顯著減少，同治療第1天比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組治療第3、5天時的大便次數(shù)少于對照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療組大便次數(shù)、性狀恢復(fù)時間、腹瀉總療程均顯著短于對照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 硫酸鋅聯(lián)合布拉酵母菌可降低抗生素相關(guān)性腹瀉的發(fā)生率，促進(jìn)抗生素相關(guān)性腹瀉病情恢復(fù)，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the effect of zinc sulfate combined with saccharomyces boulardii in prevention of antibiotic associated diarrhea in children. Methods Patients (120 cases) with bronchial pneumonia in Department of Pediatrics of Langfang Fourth People's Hospital from March 2012 to August 2015 were randomly divided into control and treatment groups, and each group had 60 cases. All patients were given symptomatic and anti-infection treatment. Patients in the control group were po administered with Saccharomyces Boulardii Sachets on the first day of the antibiotic treatment, 1-3 years old, 0.25 g/time;>3 years old, 0.25 g/time, twice daily. The patients in the treatment group were po administered with Zinc Sulfate Granules on the basis of the control group, 1-5 g/time, three times daily. The patients in two groups were treated for 3 d. If the patients had diarrhea occurred in the process of treatment, and they were used with Montmorillonite Powder immediately, and gave them rehydration therapy. After treatment, the occurrence, time, and degree of antibiotic associated diarrhea in two groups were compared. After treatment, the efficacy was evaluated, and the stool frequency, stool frequency recovery time, stool character recovery time, and diarrhea total course in two groups were recorded. Results In the process of the treatment, the incidence of antibiotic associated diarrhea in the control and treatment groups were 43.33% and 26.67%, respectively, and patients of mild, moderate diarrhea in the treatment group were lower than those in the control group, and there were differences between two groups (P<0.05). Diarrhea occurred time in the treatment group was significantly later than that in the control group, and there were differences between two groups (P<0.05). The clinical efficacies in the control and treatment groups were 61.54% and 81.25%, respectively, and there were differences between two groups (P<0.05). On the first day of the treatment, there was no statistical significance between two groups about the stool frequency. On the third and fifth day of the treatment, stool frequency decreased significantly, and the difference was statistically significant in the same group compared to the first day of treatment (P<0.05). The stool frequency on the third and fifth day in the treatment group was less than those in the control group, and there were differences between two groups (P<0.05). The stool frequency recovery time, stool character recovery time, and diarrhea total course in the treatment group were shorter than those in the control group, and there were differences between two groups (P<0.05). Conclusion Zinc sulfate combined with saccharomyces boulardii can reduce the incidence of antibiotic associated diarrhea, and can promote disease situation recovery, which has a certain clinical application value.

廊坊市科技支撐計(jì)劃項(xiàng)目