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目的探讨小儿肺炎继发腹泻的危险因素及应用微生态制剂(培菲康)预防的效果。方法调查2002年1月至2004年5月在福建医科大学附属第一医院住院治疗的小儿肺炎314例,以住院期间抗生素治疗同时应用微生态制剂(培菲康)的患儿为病例组,仅使用抗生素治疗或住院72h后因出现继发腹泻才开始应用微生态制剂(培菲康)的患儿为对照组,对肺炎患儿的临床特征、微生态制剂的应用情况与继发腹泻的关系进行单因素卡方分析和非条件Logistic回归模型多因素分析。结果病例组114例,住院治疗期间继发腹泻病21例,发生率为18.4%;对照组200例,继发腹泻79例,发生率39.5%。单因素卡方分析显示:患儿发病年龄、住院天数、住院后有无侵入性操作、微生态制剂的应用、居住地、病情严重程度、血中性粒细胞、血红蛋白数量、激素应用与小儿肺炎继发腹泻有关联。非条件Logistic多因素回归分析筛选出3个危险因素,即患儿年龄(χ2=14.120,P=0.000)、住院天数(χ2=11.532,P=0.001)、入院后接受侵入性操作(χ2=6.827,P=0.009)和1个保护因素:微生态制剂应用(χ2=12.943,P=0.000)。结论肺炎患儿年龄越小、住院时间越长或进行侵入性操作可增加继发腹泻的发生率;微生态制剂能够降低小儿肺炎继发腹泻的发生率,提示具有预防作用。

Associated factors analysis and probiotics protection in diarrhea of children with pneumonia

??AbstractObjectiveTo investigate correlation factors of diarrhea in children with pneumonia and assess the efficacy of probiotics (Bifico,oral capsules of live combined Bifidobacterium,Lactobacillus and Enterococcus) in diarrhea in children with pneumonia who were treated in hospital over 3 days. MethodsA total of 420 children with pneumonia were reviewed from Jan.2002 to May 2004.The final study population consisted of 314 children from 1 month to 13 years (mean:2??74 years).Analysis of variance (ANOVA) study and nonconditional multiplicity logistic regression model analysis were used to analyze the relationships between the clinical features of children with pneumonia,the use of Bifico and diarrhea in children with pneumonia.The data were managed by EPI Info 5??01a and analyzed by SPSS(Version 10??0). ResultsThe morbidity was 18??4% in case group treated with the use of Bifico; and 39??5% in the control group were treated without Bifico or with Bifico because of diarrhea 3 days later.ANOVA indicated:age,hospitalization day,residence place,severity of pathogenetic condition,blood granulocyte count,Hb,the use of hormone,Bifico and invaded operations in hospital were related to diarrhea in children with pneumonia.Nonconditional multiplicity logistic regression model analysis showed that age(??2=14??120??P=0??000),hospitalization day(??2=11??532??P=0??001) and invaded operations in hospital(??2=6??827??P=0??009) were risk factors.The prophylactic use of probiotics was an independent protective factor(??2=12??943??P=0??000). ConclusionLonger hospitalization days,younger age and invaded operations in hospital may increase the incidence of diarrhea in children with pneumonia.Probiotics may be used to reduce the morbidity of diarrhea of children with pneumonia.