枯草杆菌二联活菌颗粒联合蒙脱石散治疗NEC小肠造瘘术后患儿的效果及对免疫功能的影响  

Effect of Bacillus subtilis bivalent viable granules combined with montmorillonite dispersion on the treatment of NEC after enterostomy and its influence on immune function

作　　者：马林 胡博[1] 戴春娟[1] 杨福江 杜晓斌[1] 王金虎[1] 赵绪稳[1] MA Lin;HU Bo;DAI Chunjuan(Department of Neonatal Surgery,Tianjin Children's Hospital,Tianjin 300202,CHINA)

机构地区：[1]天津市儿童医院新生儿外科,300202

出　　处：《江苏医药》2023年第10期1016-1019,1023,共5页Jiangsu Medical Journal

基　　金：天津市儿童医院发展基金项目(2020006);天津市医学重点学科(专科)建设项目(TJYXZDXK-040A)。

摘　　要：目的 探讨枯草杆菌二联活菌颗粒联合蒙脱石散治疗新生儿坏死性小肠结肠炎(NEC)小肠造瘘术后患儿的效果及对免疫功能的影响。方法 行小肠造瘘术的NEC患儿59例分为两组,在术后肠内营养期间,对照组(27例)给予蒙脱石散,观察组(32例)在对照组的基础上联合枯草杆菌二联活菌颗粒进行治疗。比较两组患儿高流量腹泻及喂养不耐受发生比例、术后达全肠内营养时间、住院时间、每日体重增量。术前及术后10 d检测T淋巴细胞亚群和免疫球蛋白。结果观察组患儿高流量腹泻和喂养不耐受比例少于对照组(P<0.05),术后达全肠内营养时间早于对照组(P<0.05),住院时间短于对照组(P<0.05),每日体重增量优于对照组(P<0.05)。术后10 d,两组CD3^(+)T淋巴细胞、CD4^(+)T淋巴细胞、CD4^(+)/CD8^(+)T淋巴细胞比值、IgA和IgM均较术前升高,且观察组高于对照组(P<0.05)。结论 NEC小肠造瘘术后采用枯草杆菌二联活菌颗粒联合蒙脱石散进行治疗,可减少高流量腹泻和喂养不耐受的发生,更早达到全肠内营养,缩短住院时间,并可改善患儿的免疫功能。Objective To investigate the effect of Bacillus subtilis bivalent viable granules combined with montmorillonite dispersion on the treatment of necrotizing enterocolitis of newborn(NEC)after enterostomy and its influence on immune function.Methods A total of 59cases with NEC underwent enterostomy were divided into two groups.During postoperative enteral nutrition,group A(27cases)was given montmorillonite dispersion,and group B(32cases)was treated with Bacillus subtilis bivalent viable granules on the basis of group A.The proportions of the patients with high-flow diarrhea and feeding intolerance,postoperative time to total enteral nutrition,hospital stay and daily weight gain were compared between the two groups.The T lymphocyte subsets and immunoglobulin were detected before and 10days after surgery.Results The proportions of the patients with high-flow diarrhea and feeding intolerance were lower,postoperative time to total enteral nutrition was earlier,hospital stay was shorter,and daily weight gain was better in group B than those in group A(P<0.05).The CD3^(+)T lymphocyte,CD4^(+)T lymphocyte,CD4^(+)T lymphocyte/CD8^(+)T lymphocyte,IgA and IgM were higher at 10days after treatment than those before in two groups,which were higher in group B than those in group A 10days after treatment(P<0.05).Conclusion Bacillus subtilis bivalent viable granules combined with montmorillonite dispersion in the treatment of NEC after enterostomy can reduce the occurrence of high-flow diarrhea and feeding intolerance,reach total enteral nutrition earlier,shorten hospital stay,and improve the immune function.

关 键 词：新生儿坏死性小肠结肠炎 小肠造瘘术 枯草杆菌二联活菌颗粒 蒙脱石散 免疫功能 

分 类 号：R722[医药卫生—儿科]