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目的:探讨预防性应用布拉氏酵母菌(Saccharomyces boulardii,SB)对早产儿坏死性小肠结肠炎(necrotizing enterocolitis,NEC)的保护作用及可能机制,为新生儿科预防性应用SB防治NEC提供科学依据。方法:采用随机、双盲、安慰剂对照的前瞻性研究评估预防性使用微生态制剂SB在降低早产儿NEC发病率方面的作用。选取2011年7月1日～12月31日新入住南京医科大学附属淮安市第一医院新生儿科且符合病例选择标准的早产患儿共计255例作为研究对象,随机分为2组,治疗组喂以SB,每天1次,持续30 d(或至出院),对照组喂以安慰剂。患儿分组情况对于临床医生设盲。观察达到完全肠内喂养时间及早产儿NEC发病率(按Bell分级≥2级)。结果:共239例早产患儿被纳入研究队列,2组患儿例数及相关参数具有临床可比性。治疗组达到完全肠内营养时间为(16.5±6.7)d,对照组为(19.1±6.2)d,治疗组患儿达到完全肠内营养时间短于对照组,差异具有统计学意义(P<0.05)。121例治疗组中确诊为NEC者1例,发病率0.83%;118例对照组中确诊为NEC 6例,发病率5.08%。治疗组早产儿NEC发病率低于对照组,差异具有统计学意义(P<0.05)。结论:早产儿预防性应用SB可缩短达到完全肠内营养时间,降低NEC发生率。
Objective: To investigate the protective effect of prophylactic use of Saccharomyces boulardii (SB) on necrotizing enterocolitis (NEC) in premature infants and its possible mechanism, to provide a scientific basis for prophylactic use of SB in prevention and treatment of NEC in neonates . METHODS: A prospective randomized, double-blind, placebo-controlled prospective study was conducted to evaluate the role of prophylactic use of probiotics SB in reducing the incidence of NEC in preterm infants. A total of 255 preterm infants who were admitted to Department of Neonatology, the First Affiliated Hospital of Huai’an City, Nanjing Medical University from July 1, 2011 to December 31, 2011 were selected and divided into two groups randomly. The treatment group The patients in the control group were given placebo once a day for 30 days (or discharged). The grouping of children blinds clinicians. Observed to achieve complete enteral feeding time and preterm neonates with NEC incidence (by Bell classification ≥ 2). Results: A total of 239 premature infants were enrolled in the cohort. The number of children and related parameters in two groups were clinically comparable. The complete enteral nutrition time was (16.5 ± 6.7) days in the treatment group and (19.1 ± 6.2) days in the control group, and the time to complete enteral nutrition was shorter in the treatment group than in the control group (P <0.05) ). In 121 cases of treatment group, 1 case was diagnosed as NEC, the incidence rate was 0.83%; 118 cases of control group were diagnosed as NEC in 6 cases, the incidence rate was 5.08%. The incidence of NEC in treatment group was lower than that in control group, the difference was statistically significant (P <0.05). Conclusion: Preventive use of SB may shorten the time to complete enteral nutrition and reduce the incidence of NEC.