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目的:观察益生菌制剂在预防和治疗老年重症肺部感染中抗生素相关性腹泻的临床疗效。方法:于2014年6月-2015年10月期间选取≥60岁的60例老年肺部感染患者,随机分为治疗组(31例)与对照组(29例),均使用广谱抗生素抗感染治疗,治疗组加用益生菌制剂(复合乳酸杆菌)。观察和分析两组患者发生腹泻的情况,及使用抗生素前及使用后第5、10、15天大便常规、菌群状况。结果:对照组在使用抗生素后10天后肠道有益菌(乳杆菌、双歧菌)明显减少,而肠杆菌明显增加(P<0.05),治疗组与对照组比较,肠杆菌数量在15天时为下降,乳杆菌和双歧菌在第10天均有上升,与对照组比较有差异(P<0.05),治疗组AAD发生率为12.90%,相比对照组的41.38%有差异(P<0.05),出现腹泻的时间与腹泻持续天数两组均有差异。结论:在使用抗生素的老年肺部感染患者中,肠道内的有益菌均有不同程度的减少,而益生菌(复合乳酸菌)的应用,可纠正肠道菌群失调,有效保持肠道菌群稳态,对预防和治疗抗生素相关性腹泻有重大意义。
Objective: To observe the clinical efficacy of probiotics in the prevention and treatment of antibiotic-associated diarrhea in elderly patients with severe pulmonary infection. Methods: From June 2014 to October 2015, 60 elderly patients with pulmonary infection ≥60 years old were selected and randomly divided into treatment group (n = 31) and control group (n = 29), all of whom were treated with broad-spectrum antibiotics Treatment, treatment group plus probiotic preparation (Lactobacillus complex). Observation and analysis of diarrhea occurred in two groups of patients, and before using antibiotics and 5,10,15 days after use stool routine, flora status. Results: In the control group, the number of beneficial bacteria (Lactobacillus and Bifidobacteria) in intestinal tract decreased significantly after 10 days and that of Enterobacteriaceae significantly increased (P <0.05). The number of Enterobacteriaceae in treatment group and control group was (P <0.05). The incidence of AAD in the treatment group was 12.90%, which was significantly different from that of the control group (41.38%, P <0.05) ), Diarrhea and diarrhea duration of the two groups were different. Conclusion: In the elderly patients with antibiotics in the elderly pulmonary infection, the beneficial bacteria in the intestine have varying degrees of reduction, and the application of probiotics (composite lactic acid bacteria), can correct the imbalance of intestinal flora, effectively maintain the stability of intestinal flora State, to prevent and treat antibiotic-related diarrhea is of great significance.