目的探讨复配益生菌制剂治疗危重症患者抗生素相关性腹泻的临床效果。方法选取新疆维吾尔自治区人民医院重症监护室2015年12月至2016年12月住院并诊断为抗生素相关性腹泻的患者80例,随机分为观察组和对照组。两组患者均给予基础治疗加营养治疗。在营养治疗方面,对照组患者给予常规营养治疗,观察组患者在常规营养治疗的基础上加用复配益生菌制剂,30g/d,连用6d。观察两组患者在治疗前、治疗后第3天、第6天的肝功能,包括谷丙转氨酶(ALT)、谷草转氨酶(AST),肾功能(血肌酐、尿素氮),营养状况(白蛋白、总蛋白),炎症指标(C反应蛋白、降钙素原)的变化,并进行临床疗效及安全性评定。结果治疗6d后,观察组患者肝功能、肾功能较对照组明显改善,差异有统计学意义(P<0.05);治疗6d后,观察组患者白蛋白水平明显升高,差异有统计学意义(P<0.05),而两组患者总蛋白水平差异无统计学意义(P>0.05);治疗后第3天、第6天观察组患者炎症指标显著低于对照组,两组相比差异有统计学意义(P<0.05)。观察组患者临床总有效率为95.0%,明显高于对照组的72.5%,差异有统计学意义(Z=2.437,P<0.05)。结论复配益生菌制剂调节机体肠道菌群,恢复体内微生态平衡,对治疗危重症患者抗生素相关性腹泻疗效显著,安全性好,能有效改善危重症患者营养状况、肝肾功能,提高机体免疫力,减少炎症反应,从而提高危重症患者的预后,值得广泛推广应用。 Objective To investigate the clinical efficacy of compound probiotics in the treatment of antibiotic-associated diarrhea in critically ill patients. Methods Eighty patients admitted to ICU of ICU from December 2015 to December 2016 in Xinjiang Uygur Autonomous Region and diagnosed as antibiotic-associated diarrhea were randomly divided into observation group and control group. Two groups of patients were given basic treatment plus nutrition treatment. In the aspect of nutrition treatment, patients in the control group were given routine nutritional therapy. Patients in the observation group were given probiotics supplemented with conventional probiotics at 30g / d for 6 days. The liver function, including ALT, AST, renal function (serum creatinine, urea nitrogen), nutritional status (albumin , Total protein), inflammatory markers (C-reactive protein, procalcitonin) changes, and clinical efficacy and safety assessment. Results After 6 days of treatment, the liver function and renal function in the observation group were significantly improved compared with the control group (P <0.05). After 6 days of treatment, the albumin level in the observation group was significantly increased, with significant difference (P < P <0.05). There was no significant difference in the total protein levels between the two groups (P> 0.05). On the 3rd and 6th day after treatment, the inflammation index in the observation group was significantly lower than that in the control group Significance (P <0.05). The total clinical effective rate in the observation group was 95.0%, which was significantly higher than that in the control group (72.5%), the difference was statistically significant (Z = 2.437, P <0.05). Conclusion The compound probiotics can regulate the intestinal microflora in the body and restore the microecological balance in vivo. It is effective in treating antibiotic-associated diarrhea in critically ill patients and has good safety. It can effectively improve the nutritional status, liver and kidney function, Immunity, reduce the inflammatory response, thereby improving the prognosis of critically ill patients, it is worth to widely promote the application.