初乳口腔免疫治疗对降低极低出生体重早产儿医院感染发生率的临床意义 : = Clinical significance of oral immune therapy with colostrum on reducing incidence of nosocomial infection in very low birth weight preterm infants

目的探讨初乳口腔免疫治疗对降低极低出生体重(VLBW)早产儿医院感染(nosocomial infection, hospital infection, hospital acquired infection)发生率的临床疗效。方法选择2016年5月至2018年4月,于南京医科大学附属无锡妇幼保健院新生儿重症监护病房(NICU)住院治疗的198例VLBW早产儿为研究对象。根据监护人意愿及母亲是否能在受试儿生后72 h内提供初乳,将其分为观察组(n=108,接受初乳口腔免疫治疗)和对照组(n=90,采用等量生理盐水替代初乳治疗)。采用t检验及χ~2检验等,对2组受试儿的临床资料、医院感染发生率及临床结局进行统计学比较。本研究通过本院伦理委员会审批(审批文号:2018-06-0328-02),并获得监护人或授权委托人的知情同意。结果①2组患儿胎龄、出生体重、小于胎龄儿比例、头围、性别及分娩方式构成比、胎膜早破>18 h发生率、母亲产前抗菌药物使用率、新生儿窒息发生率、静脉营养时间、双胎比例及动脉导管未闭发生率比较,差异均无统计学意义(P>0.05)。观察组患儿中心静脉置管率(38.9%)及机械通气治疗率(32.4%),均显著高于对照组(25.6%、14.4%),并且差异均有统计学意义(χ~2=3.958、P=0.047,χ~2=8.625、P=0.003)。②观察组患儿医院感染总发生率及临床败血症发生率分别为21.3%、13.0%,显著低于对照组的34.4%、25.6%,并且差异均有统计学意义(χ~2=4.279、P=0.039,χ~2=5.123、P=0.024)。2组患儿确诊败血症、呼吸机相关性肺炎(VAP)及尿路感染发生率比较,差异均无统计学意义(P>0.05)。③2组患儿住院时间、出院时头围及体重、好转出院率比较,差异均无统计学意义(P>0.05)。结论初乳口腔免疫治疗,可降低VLBW早产儿的医院感染发生率。.

Objective To investigate the effect of oral immune therapy with colostrum on reducing incidence of nosocomial infection in very low birth weight(VLBW) preterm infants. Methods A total of 198 VLBW preterm infants who were hospitalized in neonatal intensive care unit(NICU) of the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University from May 2016 to April 2018, were enrolled as research subjects. They were divided into observation group(n=108, treated by oral immune therapy with colostrum) and control group(n=98, treated by equal amount of normal saline to replacing colostrum) based on informed consent and offer colostrum or not within the first 72 h after VLBW preterm infants birth. The independent-samples t test and chi-square test were used to compare the clinical data, incidence rate of nosocomial infection and clinical outcomes between two groups of patients. This study was reviewed by the Ethics Committee of the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University(Approval No. 2018-06-0328-02). Informed consents were obtained from the guardians or entrusted agents of all infants. Results ①There were no significant differences between two groups of VLBW preterm infants in gestational age, birth weight, proportion of small for gestational age, head circumference, constituent ratio of gender and delivery mode, incidence rate of time of premature rupture of membranes >18 h, usage of prenatal antibacterials in mother, incidence rate of asphyxia of infants, time of parenteral nutrition, proportion of twins and incidence rate of patent ductus arteriosus(P>0.05). The rate of central venous catheterization and mechanical ventilation were 38.9% and 32.4% in observation group, which were higher than those of 25.6% and 14.4% in control group, and the differences were statistically significant(χ~2=3.958, P=0.047; χ~2=8.625, P=0.003). ②The total incidence rate of nosocomial infection and clinical sepsis were 21.3% and 13.0% in observation group, which were lower than those of 34.4% and 25.6% in control group, and the differences were statistically significant(χ~2=4.279, P=0.039; χ~2=5.123, P=0.024). There were no significant differences between two groups in the incidence rates of proven sepsis, ventilator associated pneumonia(VAP) and urinary tract infection(P>0.05). ③There were no significant differences between two groups in length of hospital stay, head circumference and weight on the day of discharge, and discharge rate of improved disease conditions(P>0.05). Conclusions Oral immune therapy with colostrum can reduce the incidence of nosocomial infection in VLBW preterm infants..

Medienart:	E-Artikel

Erscheinungsjahr:	2019-10-01 2019
Erschienen:	2019-10-01

Enthalten in:	Zur Gesamtaufnahme - year:2019
Enthalten in:	Zhong hua fu you lin chuang yi xue za zhi - (2019), 05 vom: 01. Okt., Seite 535-540 Original Letters: Enthalten in 中华妇幼临床医学杂志 (DE-600)2999364-7 (DE-600)2999364-7 四川省成都市

Reihe:	China Academic Journals (CAJ), E, 医药卫生科技 = Medicine & Public Health

Sprache:	Chinesisch

Weiterer Titel:	Clinical significance of oral immune therapy with colostrum on reducing incidence of nosocomial infection in very low birth weight preterm infants

Beteiligte Personen:	杨莹 [VerfasserIn] 周勤 [Sonstige Person] 姜善雨 [Sonstige Person] 王敏 [Sonstige Person] 梅英姿 [Sonstige Person] 余仁强 [Sonstige Person]

Links:	oversea.cnki.net [lizenzpflichtig]

Themen:	交叉感染 儿科学 免疫疗法 初乳 医药、卫生 医药卫生科技 南京医科大学附属无锡妇幼保健院新生儿科 婴儿,早产 婴儿,极低出生体重 新生儿、早产儿疾病 肺炎,呼吸机相关性 重症监护病房,新生儿 Colostrum Cross infection Immunotherapy Infant,premature Infant,very low birth weight Intensive care units,neonatal Medicine & Public Health Paediatrics Pneumonia,ventilator-associated

Anmerkungen:	Author info:Yang Ying;Zhou Qin;Jiang Shanyu;Wang Min;Mei Yingzi;Yu Renqiang;Department of Neonatology, the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University

Förderinstitution / Projekttitel:

PPN (Katalog-ID):	CAJ641527004