目的 研究硫酸锌联合布拉酵母菌预防儿童抗生素相关性腹泻的临床疗效。方法 选取2012年3月-2015年8月廊坊市第四人民医院儿科收治的120例支气管肺炎患儿，随机分为对照组和治疗组，每组各60例。入院后所有患儿进行对症以及抗感染治疗。对照组患儿在抗生素治疗的第一天开始口服布拉酵母菌散，1~3岁，0.25 g/次，1次/d；年龄>3岁，0.25 g/次，2次/d。治疗组患儿在对照组治疗基础上口服硫酸锌颗粒，1~5 g/次，3次/d。两组均连续治疗3 d。在治疗过程中如果有腹泻发生，立即使用蒙脱石散，并进行补液治疗。观察两组抗生素相关性腹泻的发生时间、发生率并对腹泻程度进行分级。观察两组的临床疗效，记录两组患儿的大便次数、大便次数恢复时间、大便性状恢复时间及腹泻总疗程。结果 治疗过程中，对照组和治疗组抗生素相关性腹泻的发生率分别为43.33%、26.67%，治疗组轻度、中度腹泻患者少于对照组，两组比较差异有统计学意义（P<0.05）。治疗组腹泻发生时间明显晚于对照组，两组比较差异有统计学意义（P<0.05）。对照组和治疗组的总有效率分别为61.54%、81.25%，两组比较差异有统计学意义（P<0.05）。治疗第1天时，两组患儿的大便次数比较无统计学意义；第3、5天时，两组患儿大便次数显著减少，同治疗第1天比较差异有统计学意义（P<0.05）；且治疗组治疗第3、5天时的大便次数少于对照组，两组比较差异有统计学意义（P<0.05）。治疗组大便次数、性状恢复时间、腹泻总疗程均显著短于对照组，两组比较差异有统计学意义（P<0.05）。结论 硫酸锌联合布拉酵母菌可降低抗生素相关性腹泻的发生率，促进抗生素相关性腹泻病情恢复，具有一定的临床推广应用价值。

Objective To investigate the effect of zinc sulfate combined with saccharomyces boulardii in prevention of antibiotic associated diarrhea in children. Methods Patients (120 cases) with bronchial pneumonia in Department of Pediatrics of Langfang Fourth People's Hospital from March 2012 to August 2015 were randomly divided into control and treatment groups, and each group had 60 cases. All patients were given symptomatic and anti-infection treatment. Patients in the control group were po administered with Saccharomyces Boulardii Sachets on the first day of the antibiotic treatment, 1-3 years old, 0.25 g/time;>3 years old, 0.25 g/time, twice daily. The patients in the treatment group were po administered with Zinc Sulfate Granules on the basis of the control group, 1-5 g/time, three times daily. The patients in two groups were treated for 3 d. If the patients had diarrhea occurred in the process of treatment, and they were used with Montmorillonite Powder immediately, and gave them rehydration therapy. After treatment, the occurrence, time, and degree of antibiotic associated diarrhea in two groups were compared. After treatment, the efficacy was evaluated, and the stool frequency, stool frequency recovery time, stool character recovery time, and diarrhea total course in two groups were recorded. Results In the process of the treatment, the incidence of antibiotic associated diarrhea in the control and treatment groups were 43.33% and 26.67%, respectively, and patients of mild, moderate diarrhea in the treatment group were lower than those in the control group, and there were differences between two groups (P<0.05). Diarrhea occurred time in the treatment group was significantly later than that in the control group, and there were differences between two groups (P<0.05). The clinical efficacies in the control and treatment groups were 61.54% and 81.25%, respectively, and there were differences between two groups (P<0.05). On the first day of the treatment, there was no statistical significance between two groups about the stool frequency. On the third and fifth day of the treatment, stool frequency decreased significantly, and the difference was statistically significant in the same group compared to the first day of treatment (P<0.05). The stool frequency on the third and fifth day in the treatment group was less than those in the control group, and there were differences between two groups (P<0.05). The stool frequency recovery time, stool character recovery time, and diarrhea total course in the treatment group were shorter than those in the control group, and there were differences between two groups (P<0.05). Conclusion Zinc sulfate combined with saccharomyces boulardii can reduce the incidence of antibiotic associated diarrhea, and can promote disease situation recovery, which has a certain clinical application value.

廊坊市科技支撑计划项目