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目的:分析并探究不同分娩方式对新生儿出生后3 d内肠道菌群定植及大便性状的影响。方法:选取2015年8-12月于我院出生的86例足月新生儿作为研究对象,其中经剖宫产分娩的49例新生儿纳入剖宫产组,经阴道自然分娩的37例新生儿纳入自然分娩组,分别采集新生儿分娩后3 d内每天的大便标本并对其性状进行评分,采用实时荧光定量技术对大便中的双歧杆菌、乳酸杆菌进行定量检测。结果:剖宫产组与自然分娩组大便频率为(2.8±1.1)次/天vs(2.4±0.9)次/天、性状评分(2.9±0.4)分vs(3.0±0.5)分(P>0.05);剖宫产组患儿大便p H高于自然分娩组(6.9±1.0 vs 5.9±0.7,P<0.05)。剖宫产组与自然分娩组生后第1天粪便双歧杆菌数量差异不明显[(5.63±0.65)lg拷贝数/g vs(5.70±0.72)lg拷贝数/g,P>0.05],但生后第2天、第3天剖宫产组的双歧杆菌数量少于自然分娩组[(6.34±1.01)lg拷贝数/g vs(7.38±1.11)lg拷贝数/g、(6.61±1.07)lg拷贝数/g vs(7.81±1.31)lg拷贝数/g],差异有统计学意义(P<0.05);而生后3 d内,生后第1天、第2天、第3天剖宫产组的乳酸杆菌数量始终少于自然分娩组[(4.62±0.72)lg拷贝数/g vs(5.81±0.39)lg拷贝数/g,(4.70±0.82)lg拷贝数/g vs(6.35±0.98)lg拷贝数/g、(5.14±0.54)lg拷贝数/g vs(6.93±0.34)lg拷贝数/g],差异有统计学意义(P<0.05)。结论:自然分娩有利于新生儿早期肠道菌群的定植,而剖宫产则会影响这些菌群的正常定植。
OBJECTIVE: To analyze and explore the effects of different modes of delivery on intestinal flora colonization and stool performance within 3 days after birth. Methods: Totally 86 full-term newborns born in our hospital from August to December in 2015 were enrolled. Among them, 49 newborns delivered by cesarean section were included in the cesarean section group, and 37 newborns with vaginal natural delivery The spontaneous delivery group was enrolled. The stool specimens of newborns within 3 days after delivery were collected and their traits were scored respectively. Quantitative detection of bifidobacteria and lactobacilli in stool was performed by real-time fluorescence quantitative assay. Results: The stool frequency in the cesarean section group and the spontaneous delivery group was (2.8 ± 1.1) days / day vs (2.4 ± 0.9) days / day, and the trait score was 2.9 ± 0.4 vs 3.0 ± 0.5 (P> 0.05 ). The stool p value of cesarean section group was higher than that of spontaneous delivery group (6.9 ± 1.0 vs 5.9 ± 0.7, P <0.05). There was no significant difference in the number of Bifidobacterium faecalis between the cesarean section group and the spontaneous delivery group [(5.63 ± 0.65) lg copies / g vs (5.70 ± 0.72) lg copies / g, P> 0.05] The number of bifidobacteria in the cesarean section on the second day and the third day after birth was less than that of the spontaneous delivery group [(6.34 ± 1.01) lg / g vs (7.38 ± 1.11) lg copies / g, (6.61 ± 1.07 ) was significantly higher than that of the control group (P <0.05). However, there was a significant difference between the two groups (P <0.05) The number of lactobacilli in the cesarean section group was always less than that in the spontaneous delivery group [(4.62 ± 0.72) lg copies / g vs (5.81 ± 0.39) lg copies / g, (4.70 ± 0.82) lg copies / g vs ± 0.98) lg copies / g, (5.14 ± 0.54) lg copies / g vs (6.93 ± 0.34) lg copies / g], the difference was statistically significant (P <0.05). Conclusion: Natural delivery is beneficial to early colonization of newborns, whereas cesarean delivery will affect the normal colonization of these colonies.