选择性肠道去污对小儿MODS防治效果的临床观察  

The efficiency of selective decontamination of the digestive tract for the treatment of children with MODS

作　　者：曾萍[1] 杨镒宇[1] 曾其毅[1] 张剑晖[1] 吴艳兰[1] 谢志伟[1] 高媛媛[1] 陶莉[1] 韦茹[1] 陶建平[1] 

机构地区：[1]广州市儿童医院,广东广州510120

出　　处：《中国小儿急救医学》2006年第2期121-123,共3页Chinese Pediatric Emergency Medicine

基　　金：广州市科技局科研项目(2003Z2-E0181);广东省科技厅科研项目(2003B30503)

摘　　要：目的 研究选择性肠道去污（SDD）对小儿MODS的防治效果。方法 2004年4月～2005年6月在ICU住院的符合MODS诊断的患儿60名，随机分成常规治疗组M1组（30名），常规治疗＋口服庆大治疗（SDD）M2组（30名），分析研究治疗前、后两组患儿的血清炎症介质的变化、并发症的发生率和病死率。结果M1组在ICU的平均住院时间为（14．68±4．8）d,M2组为（9．69±1．56）d，（p〈0．05）；Ml组出现感染并发症的人数多于M2组；M2组患儿中性粒细胞计数在治疗期间下降更为明显；M1组患儿血清TNF浓度在治疗前、后没有显著变化，M2组血清TNF浓度在治疗后明显降低。结论选择性肠道去污的治疗能有效减轻并发症，缩短病程，能否降低病死率有待进一步探讨。Objective To investigate the efficiency of selective decontamination of the digestive tract （SDD） for the treatment of children with MODS. Methods From April 2004 to June 2005,60 children with MODS in ICU were randomly divided into two groups, normal treatment group （ M1 ） and normal treatment plus gentamycin orally taken group （M2）. The cytokine change, complication and mortality were investigated in two groups during the treatment. Results The M1 group＇s average treating time in ICU was （14.68 ± 4.8） days and the M2 group was （9.69 ± 1.56） days, （P 〈 0.05）. The complication of M1 was higher than that in M2. The neutrophill counting in two groups decreased after treatment. The reduction in M2 was more apparent. The serum concentration of TNF in M1 was not changed during treatment. And the TNF concentration in M2 decreased obviously after SOD treatment. Conclusion The SDD treatment can efficaciously reduce complication and the length of hospital stay. Whether SOD can lewer mortality remains unclear.

关 键 词：选择性肠道去污 小儿 MODS 

分 类 号：R720.597[医药卫生—急诊医学]