摘要
目的 探讨结直肠癌患者术前补充双歧三联活菌对术后免疫状况和炎性反应的影响.方法 60例患者入院后按随机数字表法分为治疗组和对照组.治疗组30例术前5 d起在常规肠内营养基础上口服双歧三联活菌：对照组30例术前肠道准备按传统方法进行.两组患者手术前3d和术后第1次自然排便（术后3～5 d）时分别留取粪便作肠道菌群分析,检测粪便SIgA;术前1 d和术后1、9 d进行免疫和炎性反应指标检测,并观察患者术后感染并发症发生情况.结果 术后治疗组患者双歧杆菌（B）/大肠杆菌（E）比值（2.01±0.36）较术前（26.53±4.22）明显下降（P＜0.05）,但仍大于1：对照组患者手术前后B/E比值（0.72±0.14和0.02±0.06）均明显低于治疗组（P＜0.05）.术前两组免疫和炎性反应指标检测结果差异无统计学意义（P＞0.05）.术后第1天,两组患者免疫球蛋白、淋巴细胞总数和粪便SIgA均下降,炎性因子均上升.术后第9天,两组患者血清IgG水平逐渐上升,但治疗组显著高于对照组（P＜0.05）,而血清IL-6和C反应蛋白水平显著低于对照组（P＜0.05）;粪便SIgA水平治疗组显著高于对照组（P＜0.05）.术后感染并发症发生率治疗组低于对照组（P＜0.05）,但术后其他并发症发生率及住院天数两组差异无统计学意义（P＞0.05）.结论 术前常规肠内营养基础上补充双歧三联活菌能改善结直肠癌患者肠道菌群失调.益于术后重建肠道菌群平衡、提高机体免疫状况和保护肠黏膜屏障功能及减轻炎性反应.
Objective To investigate the effect of preoperative use of viable bifidobacterium supplement on the intestinal flora,immune status,inflammatory response and prognosis of patients undergoing colorectal cancer resection.Methods Sixty patients with colorectal cancer were randomized into treatment group（n=30） and control group（n=30）.Patients in the treatment group received oral viable bifidobacterium with routine enteral nutrition and patients in the control group received routine enteral nutrition alone.The intestinal flora of stool was analyzed and stool SIgA,serum IgG,IgM,IgA,IL-6,and C-reactive protein （CRP） were detected.Results Postoperative bifidobacteriu/E.coli（B/E） ratio in the treatment group decreased significantly as compared to the preoperative ratio （2.01±0.36 vs.26.53±4.22,P〈0.05）.However,the ratios remained above one.Both preoperative and postoperative B/E ratios in the control group（0.72±0.14,0.02±0.06） were significantly lower than those in the treatment group（P〈0.05）.Indexes of immunity and inflammation were not significantly different between the two groups（P〉0.05）.At day 9 after operation,stool SIgA was higher in the treatment group,while serum IgG,IgM,IgA,IL-6,CRP in the treatment group were lower （P〈0.05）.Postoperative septic complications in the treatment group was less than that in the control group （P〈0.05）,but other complications and hospital stay were comparable.Conclusions In patients with colorectal cancer,supplementation of viable bifidobacterium before surgery can improve bacterial dysbiosis and immunity,and can reconstruct the balance of intestinal flora,and reduce infection complication of surgery.
出处
《中华胃肠外科杂志》
CAS
北大核心
2010年第1期40-43,共4页
Chinese Journal of Gastrointestinal Surgery
关键词
结直肠肿瘤
结直肠切除术
双歧杆菌
细菌易位
免疫球蛋白
Colorectal neoplasms
Colorectal resection
Bifidobacterium
Bacteria translocation
Immunoglobulins
