双歧三联活菌对机械通气患者发生呼吸机相关性肺炎的影响  

Effect of Live Combined Bifidobacterium and Lactobacillus Bacteria Tablets on Mechanically Ventilated Patients with Ventilator-Associated Pneumonia

作　　者：刘文娟[1] 李敏[1] 赵娜[2] 李岩[1] 孙婷[1] 王晓芝[1] 

机构地区：[1]滨州医学院附属医院重症医学科,滨州256600 [2]山东省滨州市中心医院呼吸科,滨州251700

出　　处：《医药导报》2016年第1期50-53,共4页Herald of Medicine

基　　金：山东省科技发展计划项目(2011GSFll830);山东省"泰山学者"岗位项目基金资助项目;山东省教育厅科技计划(J08LG03)

摘　　要：目的探讨双歧三联活菌对行机械通气患者呼吸机相关性肺炎(VAP)的影响。方法机械通气患者128例,随机分为治疗组63例,对照组65例。两组患者同时给予针对原发病的相应治疗,治疗组在行机械通气后给予双歧三联活菌2.0 g,po,tid,直到患者出现下列结局:发生VAP、撤机、死亡、出院。监测两组患者胃液p H值、胃液定植菌情况及VAP发生率。结果对照组与治疗组早期VAP发生率分别为16.9%,17.5%(P>0.05),晚期VAP发生率分别为36.9%,20.6%(P<0.05);胃液p H值<4的比例分别为58.3%,68.0%(P<0.05);VAP致病菌与胃肠道定植菌同源率分别为50.0%,18.5%(P<0.05)。结论双歧三联活菌可减少晚期VAP的发生,维持胃液适宜p H值。Objective To study the effect of live combined bifidobacterium and lactobacillus tablets on mechanically ventilated patients with ventilator-associated pneumonia. Methods Totally 128 cases were enrolled and randomly divided into treatment group of 63 cases and the control group of 65 cases. Both of them were given corresponding treatment for the primary disease.The patients in treatment group received live combined bifidobacterium and lactobacillus tablets（ 2.0 g,po,tid） when they accepted mechanical ventilation immediately,until one of outcomes（ VAP,withdrawal,death,discharge） occurred. The p H of gastric juice,gastric bacterial colonization,and incidence of ventilator associated pneumonia of two groups were chosen to analyze. Results The incidence of early onset VAP in the control group and treatment group were 16.9%,17.5%（ P〉0.05）,late VAP were 36.9%,20.6%（ P〈0.05）,respectively.The ratio of p H below 4 for gastric juice were 58.3%,68.0%,（ P〈0.05）; The homology ratio between VAP pathogen and gastric bacterial colonization were 50.0%,18.5%（ P〈0.05）. Conclusion Live combined bifidobacterium and lactobacillus can reduce the incidence of late onset VAP,maintaining suitable acidity of gastric juice.

关 键 词：双歧三联活菌 肺炎 呼吸机相关性 PH值 胃液 

分 类 号：R975[医药卫生—药品] R563.1[医药卫生—药学]