腹腔镜手术联合微生态制剂对结直肠癌患者肠道菌群和肠道屏障功能的影响

目的观察腹腔镜手术联合微生态制剂对结直肠癌患者肠道菌群和肠道屏障功能的影响,为临床治疗提供依据。方法选择我院2016年12至2018年12月收治的84例结直肠癌患者为研究对象。入选患者分为观察组和对照组。观察组患者采用腹腔镜手术联合口服益生菌治疗,对照组患者单纯采用腹腔镜手术治疗。比较两组患者术后恢复情况、并发症情况、肠道菌群变化和肠道屏障功能。结果观察组患者第1次完全进食时间、术后住院总时间(d)均短于对照组(9.54±0.52 vs 11.56±0.24、11.61±2.14 vs 14.94±3.65,P<0.05);观察组患者术后并发症总发生率低于对照组(9.5%vs 28.6%,P<0.05)。观察组患者术后第1次排便时肠道乳杆菌、双歧杆菌数量(lg CFU/g)大于对照组(7.21±0.35 vs 6.78±0.21、7.12±0.23 vs 6.84±0.25,P<0.05),大肠埃希菌、球杆菌数量低于对照组(8.12±0.56 vs 9.55±0.54、8.24±0.24 vs 8.85±0.25,P<0.05)。观察组患者术后第15天肠道乳杆菌、双歧杆菌数量大于对照组(9.51±0.56 vs 8.21±0.45、9.61±0.44 vs 7.85±0.23,P<0.05),大肠埃希菌、球杆菌数量低于对照组(7.22±0.36 vs 9.15±0.35、7.68±0.54 vs 8.25±0.55,P<0.05)。观察组患者术后第15天粪便sIgA水平(mg/g)大于对照组(1.21±0.13 vs 1.05±0.14,P<0.05);血清D-乳酸、尿L/M水平(μg/mL)低于对照组(5.48±0.85 vs 0.62±0.54、3.24±0.28 vs 2.68±0.54,P<0.05)。结论腹腔镜手术联合益生菌制剂可纠正并改善结直肠癌患者术后肠道微生态失调,修复并增强肠道屏障功能。

Effect of laparoscopic surgery combined with microecological agents on intestinal flora and intestinal barrier function in patients with colorectal cancer

Objective To observe the effect of laparoscopic surgery combined with microbiological preparation on intestinal flora and intestinal barrier function of patients with colorectal cancer after radical resection, so as to provide a basis for clinical treatment. Methods A total of 84 patients with colorectal cancer admitted to our hospital from Nov. 2016 to Nov. 2018 were enrolled and divided into observation group or control group. Patients in observation group were treated with laparoscopic surgery combined with oral probiotics while those in control group were treated with laparoscopic surgery alone. The postoperative recovery indexes, complications, changes in intestinal flora and intestinal barrier function of patients were compared between groups. Results The time to having first meal and total time of hospitalization(day) in the observation group were shorter than those in the control group (9.54±0.52 vs 11.56±0.24, 11.61±2.14 vs 14.94±3.65, P<0.05);The total incidence of complications in the control group was higher than that in the observation group(9.5% vs 28.6%, P<0.05);The numbers of Lactobacilli and Bifidobacteria(lg CFU/g) in the first defecation in observation group were more than those in the control group(7.21±0.35 vs 6.78±0.21, 7.12±0.23 vs 6.84±0.25, P<0.05), while those of Escherichia coli and Cocci were less than control group(8.12±0.56 vs 9.55±0.54, 8.24±0.24 vs 8.85±0.25). On the fifteenth day after surgery, the numbers of Lactobacilli and Bifidobacteria in observation group were more than those in the control group(9.51±0.56 vs 8.21±0.45, 9.61±0.44 vs 7.85±0.23, P<0.05), while those of Escherichia coli and Cocci were less than those in the control group(7.22±0.36 vs 9.15±0.35, 7.68±0.54 vs 8.25±0.55, P<0.05) respectively. Meanwhile, the fecal sIgA level(mg/g) in observation group was higher than that in control group(1.21±0.13 vs 1.05±0.14, P<0.05), while those of serum D-lactic acid(μg/mL) and urine L/M ratio were lower than those in control group(5.48±0.85 vs 0.62±0.54, 3.24±0.28 vs 2.68±0.54, P<0.05). Conclusion Laparoscopic surgery combined with bifidobacterium trifecta probiotics can correct and improve the postoperative intestinal microecological environment of patients with colorectal cancer, and repair and enhance the intestinal barrier function.