每日益生菌对极低出生体重儿坏死性小肠结肠炎发生率和严重程度的影响。
The effect of daily probiotics on the incidence and severity of necrotizing enterocolitis in infants with very low birth weight.
机构信息
From the Faculty of Medicine, University of British Columbia, Vancouver, BC (Que); the BC Women's Hospital and Health Centre, Vancouver, BC (Van Oerle); the Department of Pediatrics, Faculty of Medicine, University of British Columbia/BC Children's Hospital, Vancouver, BC (Albersheim, Panczuk); and the Division of Pediatric Surgery, University of British Columbia/BC Children's Hospital, Vancouver, BC (Piper).
出版信息
Can J Surg. 2021 Dec 1;64(6):E644-E649. doi: 10.1503/cjs.016920. Print 2021 Nov-Dec.
BACKGROUND
Necrotizing enterocolitis remains a leading cause of morbidity and mortality in premature infants. The role of prophylactic probiotics in its prevention is unclear. This study evaluates the effect of routine probiotics on the incidence and severity of necrotizing enterocolitis in infants with very low birth weight in the neonatal intensive care unit.
METHODS
This retrospective cohort study compared infants cared for at a single institution before and after implementation of routine probiotic administration (2014- 2018). Babies born after July 2016 received probiotics containing and daily until 35 weeks corrected gestational age. Baseline characteristics, necrotizing enterocolitis incidence and severity, infections, mortality, and length of stay were compared between groups.
RESULTS
Of the 665 infants included in the study, 310 received probiotics and 355 did not. The 2 groups did not differ with regard to gestational age, birth anthropometrics, mode of delivery, comorbidities, and type of enteral feed. The incidence of necrotizing enterocolitis (Bell's stage 2 of 3) was similar between groups (4% v. 5%, = 0.35), as was its severity ( = 0.10). In addition, there were no significant differences in mortality and length of stay between the groups. Significantly fewer infants receiving probiotics developed infections (27% v. 34%, = 0.046), with the rate of urinary tract infections having the largest reduction.
CONCLUSION
The routine use of and probiotics in infants with very low birth weight did not significantly affect the incidence and severity of necrotizing enterocolitis. However, the use of probiotics was associated with fewer overall infections.
背景
坏死性小肠结肠炎仍然是早产儿发病率和死亡率的主要原因。预防性益生菌在预防中的作用尚不清楚。本研究评估了常规益生菌对新生儿重症监护病房极低出生体重儿坏死性小肠结肠炎发生率和严重程度的影响。
方法
本回顾性队列研究比较了一家机构在常规益生菌给药前后（2014-2018 年）接受治疗的婴儿。2016 年 7 月后出生的婴儿接受含有 和 的益生菌，每天一次，直至校正胎龄 35 周。比较两组间的基线特征、坏死性小肠结肠炎发生率和严重程度、感染、死亡率和住院时间。
结果
本研究纳入了 665 名婴儿，其中 310 名接受了益生菌治疗，355 名未接受益生菌治疗。两组间的胎龄、出生人体测量、分娩方式、合并症和肠内喂养类型无差异。坏死性小肠结肠炎（贝尔 2 或 3 期）的发生率在两组间相似（4%比 5%，=0.35），严重程度也相似（=0.10）。此外，两组间的死亡率和住院时间无显著差异。接受益生菌治疗的婴儿感染发生率显著较低（27%比 34%，=0.046），其中尿路感染的发生率降幅最大。
结论
极低出生体重儿常规使用 和 益生菌并未显著影响坏死性小肠结肠炎的发生率和严重程度。然而，益生菌的使用与总感染率的降低有关。
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