术前补充益生菌对肠道手术患者术后肠道菌群 及肠黏膜屏障功能的影响

目的探讨术前补充益生菌对肠道手术患者术后肠道菌群及肠黏膜屏障功能的影响。方法选取肠道手术患者86例,随机分为观察组和对照组各43例。两组患者术前予以常规肠道准备,术后给予等营养支持及抗生素等治疗。观察组患者术前7 d开始加用双歧杆菌三联活菌胶囊温水口服,630 mg/次,2次/d。观察两组患者术后肠道功能恢复及感染并发症情况,并比较术前7 d及术后首次自然排便时两组患者肠道菌群数量及肠黏膜屏障指标变化。结果观察组患者术后肠鸣音恢复时间、肛门排气时间、排便时间均短于对照组(均P0.05),术后感染并发症的发生率低于对照组(P0.05)。术后首次自然排便时两组患者肠道双歧杆菌、乳杆菌数量及B/E值显著低于术前7 d时,大肠埃希菌数量高于术前7 d时(均P0.05),且观察组患者术后双歧杆菌、乳杆菌数量及B/E值均高于对照组,大肠埃希菌数量明显少于对照组(P0.05)。术后首次自然排便时两组患者血清D-乳酸和DAO水平高于术前7 d时(P0.05),且观察组患者术后D-乳酸和DAO水平低于对照组(P0.05)。结论肠道手术患者术前补充益生菌可调节肠道菌群,降低肠黏膜通透性,改善其肠道功能,减少术后感染并发症的发生率。

Influence of preoperative probiotics supplement on intestinal flora and intestinal mucosal barrier function of patients after intestinal operation

Abstract: Objective To discuss the influence of preoperative supplement of probiotics on intestinal flora and intestinal mucosal barrier function of patients after intestinal operation. Methods A total of 86 patients to be given intestinal surgery were randomly divided into observation group and control group with 43 cases in each group. The patients in two groups were treated with selective intestinal surgery, routine preoperative bowel preparation and postoperative nutrition, antibiotics and other supporting treatment; the patients in observation group were additionally given 630 mg of Bifid Triple Viable capsules b.i.d orally 7 days before operation. The recovery of intestinal function and infective complications of patients after operation were observed; the amounts of Lactobacilli, Bifidobacteria and Escherichia coli, the ratio of Bifidobacteria (B) to Escherichia coli (E) (B/E)] and intestinal mucosal barrier indexes serum D-lactic acid and diamine oxidase (DAO)] at 7 days before operation and at the first natural defecation after operation were compared between two groups. Results The times to recovery of gurgling sound, anus exhaust and defecation after operation in observation group were obviously shorter than those in control group (all P<0.05), and the incidence rate of infective complications in observation group after operation was obviously lower than that in control group (P<0.05). The amounts of Bifidobacteria and Lactobacilli and B/E ratio upon the first natural defecation after operation obviously decreased in two groups than those 7 days before operation, while the amount of Escherichia coli obviously increased (all P<0.05). The amounts of Bifidobacteria and Lactobacilli and B/E ratio in observation group after operation were much higher than those in control group, while the amount of Escherichia coli was much lower than that in control group (P>0.05), respectively. The levels of serum D-lactic acid and DAO upon the first natural defecation after operation obviously rose in both groups than those 7 days before operation (all P<0.05), and the levels in observation group were much lower than those in control group (all P<0.05) respectively. Conclusion Preoperative supplement of probiotics in patients with intestinal operation can adjust intestinal flora, lower the permeability of intestinal mucosa and reduce postoperative infective complications.