两种抗生素对新生儿感染性肺炎的疗效观察及对肠道微生态影响研究

目的 考察常用抗生素对新生儿肺炎的治疗效果以及抗生素使用对新生儿肠道微生态的影响.方法 选取杭州市第一人民医院2011年12月～2012年12月收治的无并发症的新生儿肺炎患者130例作为研究对象,依据使用不同抗生素分为头孢组30例,青霉素组29例,联合用药组31例,另选40名健康新生儿作为对照组,比较各组的治愈率、治愈时间.考察使用抗生素5d后肠道菌群数量,评价抗生素对新生儿肠道微生态的影响.结果 头孢组治愈率为76.7％;青霉素组治愈率为72.4％;联合用药组治愈率为71.2％;三组治愈率之间相比较,差异无统计学意义（P＞0.05）.头孢组治愈时间为（5.3±0.2）d,青霉素组治愈时间为（5.5±0.2）d,联合用药组治愈时间为（5.2±0.3）d,三组治愈时间比较,差异无统计学意义（P＞0.05）.用药组与对照组相比较,双歧杆菌数量明显降低（P＜0.01）,肠杆菌、肠球菌以及消化链球菌数量显著增加（P＜ 0.01或P＜ 0.05）,类杆菌数量差异无统计学意义（P＞ 0.05）.结论 抗生素治疗新生儿肺炎偏向于联合用药,抗生素会破坏新生儿肠道微生态失去平衡.

Research on two kinds of antibiotic therapeutic effect for neonates with infectious pneumonia and for intestinal microecology

Objective To observe common antibiotic therapeutic effect for neonates with infectious pneumonia and for neonatal intestinal microecology.Methods 130 neonates with infectious pneumonia and without complications from December 2011 to December 2012 in the First People＇s Hospital of Hangzhou City were selected and divided into the cephalosporins group （n =30）,the penicillins group （n =29） and the combination group （n =31）,40 health neonates were selected for control.The cure rate,cure time in these groups were compared and the intestinal microflora were calculated after 5 days with antibiotic treatment for evaluating the antibiotic effect to neonatal intestinal microecology.Results There was no significant difference between the cure rate of the cephalosporins group （76.7％）,penicillins group （72.4％） and combination group （71.2％） （P ＞ 0.05）.The cure time in the cephalosporins group,penicillins group and combination group was （5.3±0.2）,（5.5±0.2） days and （5.2t0.3） days,and there was no significant difference among these groups （P ＞ 0.05）.Bifidobacteria quantity in the drug groups was significantly lower than that in the control group （P ＜ 0.01）,while the quantity of enteric bacilli,enterococci and peptostreptococcus in the drug groups was higher than those in the control group （P ＜ 0.01 or P ＜ 0.05）,but the quantity of bacteroidosis had no significant difference among the three groups （P ＞ 0.05）.Conclusion The kind of antibiotic treatment for neonates with infectious pneumonia is lean to combination and these antibiotics can destroy neonatal intestinal microecology which will then lose balance.