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目的探讨给机械通气新生儿补充双歧杆菌是否能有效控制呼吸机相关性肺炎(VAP)肠源性感染。方法将机械通气新生儿随机分两组,观察组鼻饲双歧杆菌,对照组不干预,观察两组发生VAP的情况、胃液pH、胃细菌定植、病原菌分布、病原菌与胃定植细菌的同源性等。结果观察组VAP发生率显著低于对照组,分别为13.16%和46.51%(P<0.01)。机械通气第3天、第5天、第7天观察组pH≤3的比率均高与对照组(P<0.01);第5天及第7天观察组胃细菌定植比率均低于对照组(P<0.01);观察组病原菌与胃定植菌同源比率低于对照组(P<0.01),均具统计学意义。结论双歧杆菌可降低胃液pH,减少胃内细菌定值,抑制肠道细菌经胃-咽-下呼吸道的移位而减少新生儿肠源性VAP。
Objective To investigate if bifidobacteria supplemented with mechanically ventilated newborn can effectively control enterogenous infection of ventilator associated pneumonia (VAP). Methods Neonates with mechanical ventilation were randomly divided into two groups. Bifidobacterium nasally fed in the observation group and no intervention in the control group. The incidence of VAP, gastric pH, gastric bacterial colonization, distribution of pathogenic bacteria, homology of pathogenic bacteria and stomach colonization bacteria Wait. Results The incidence of VAP in observation group was significantly lower than that in control group (13.16% and 46.51% respectively) (P <0.01). The ratio of pH≤3 in the observation group on the 3rd, 5th and 7th day after mechanical ventilation was higher than that in the control group (P <0.01). On the 5th and 7th days, the ratio of gastric bacterial colonization in the observation group was lower than that of the control group P <0.01). The homologous ratios of pathogenic bacteria and stomach colonization bacteria in the observation group were lower than those in the control group (P <0.01), both of which were statistically significant. Conclusion Bifidobacterium can reduce the gastric pH, reduce the bacterial fixed value in the stomach and inhibit the translocation of intestinal bacteria through the stomach - pharynx - lower respiratory tract to reduce the neonatal intestinal VAP.