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婴儿乳糖不耐受症门诊与住院疗效的对比分析
作者:颜引妹 唐华 朱雨静 
单位:镇江市妇幼保健院
关键词:婴儿乳糖不耐受症 门诊治疗 住院治疗 
分类号:
出版年·卷·期(页码):2013·41·第一期(41-44)
摘要:

目的:为婴儿乳糖不耐受症寻找最佳的治疗途径。方法:将360例确诊为婴儿乳糖不耐受症的患儿分成门诊治疗组(简称门诊组,n=309)和住院治疗组(简称住院组,n=51)。门诊组给予短期无乳糖奶粉喂养,即第1~2天停母乳,予无乳糖奶粉喂养,第2~3天起视大便情况逐渐增加母乳喂养次数与喂养量,过度时间为3~7天,之后恢复母乳喂养,这种方法我们给它命名为绿色生态治疗法,因为它顺应自然规律:去除了奶粉中的乳糖,不用药物;住院组入院后予以常规检查、头孢类抗生素(50~100)mg/kg-1抗炎、蒙脱石散止泻、双歧杆菌片调理肠道菌群紊乱等。住院期间有呼吸道并发症的调整抗生素,加强呼吸道管理,同时给予止咳化痰药对症处理;有伪膜性肠炎立即停用抗生素,改用口服甲硝唑(20~30)mg/kg-1。补充水与电解质,加强营养支持。结果:平均腹泻症状好转时间门诊组为(2.74±1.575) d, 住院组为(14.30±11.597) d ,两组间比较差异有统计学意义( t′= 0.00749, P<0.01 );治疗过程中伪膜性肠炎门诊组0列(0.00%),住院组3列(0.45%),两组间比较差异有统计学意义( u =1.6528, P<0.05);呼吸道感染门诊组38列(12.298)%,住院组16列(31.373)% ,两组间比较差异有统计学意义( u =3.534, P<0.01);发病1个月内平均体重增长门诊组为(0.93±0.512)kg,住院组为(0.70±0.543)kg,两组间比较差异有统计学意义(t = 0.031695,P<0.05);医药费门诊组为(90.00±0.00)元, 住院组为(1591.85±799.207)元,两组间比较差异有统计学意义(t′= 0.001069,P<0.01)。结论:对确诊为乳糖不耐受症婴儿腹泻患儿可选择门诊治疗,指导家长进行短期无乳糖奶粉喂养,以避免住院交叉感染与抗生素滥用,有利于婴儿康复及生长发育,减少并发生症的发生及医疗费用。

Objective: Search the optimal treatment for infantile lactose intolerance. Methods: Separate 360 infants who are diagnosed as infantile lactose intolerance into outpatient treatment group (hereinafter referred to the outpatient group, n = 309 ) and inpatient treatment group ( referred to as the inpatient group, n = 51 ). The outpatient group is given a short term lactose-free formula feeding, i.e. stop breast milk in first 1-2 days and use lactose-free formula feeding, from the 2nd-3rd day, gradually increase the feeding frequency and quantity depending on the defecation situation. The transition time lasts for 3 to 7 days, and then the breast milk feeding is restored. This method is named the ecological treatment method, because it conform to the laws of nature: removal of lactose in milk, no drugs. The inpatient group is given a routine examination, cephalosporins ( 50 ~ 100 ) mg / kg-1 for inflammation, montmorillonite powder for diarrheal and Bifidobacterium tablets for intestinal flora disturbance . During hospitalization, for those who have respiratory complications, the antibiotic is adjusted, the management of respiratory is strengthen and simultaneously the Cough and phlegm medicine treatment is given; for those who have pseudomembranous colitis, the antibiotic is immediately stopped, and is replaced by an oral metronidazole ( 20 ~ 30 ) mg / kg-1 and supplement of water and electrolyte and nutrition support are given. Results: The average turnaround time for symptoms of diarrhea: Outpatient group ( 2.74 + 1.575) d, inpatient group ( 14.30 + 11.597) d. There is a significant difference ( t = 0.00749, P < 0.01 ) between the two groups; The pseudomembranous colitis during the treatment: Outpatient group has 0 case (0% ), inpatient group has 3 cases (0.45%). There is a significant difference (u =1.6528, P<0.05) between the two groups; Respiratory infection: Outpatient group has 38 cases ( 12.298 ) %, inpatient group has 16 cases (31.373 ) %. There is a sig

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