粪菌移植在体外循环术后肠道菌群失调患者中的应用

目的 研究粪菌移植在体外循环术后肠道菌群失调患者中的应用，探讨其有效性及安全性。方法 回顾性分析2015年1月—2017年12月兰大一院心外科重症监护室行粪菌移植治疗肠道菌群失调的患者20例，对比治疗前及治疗后患者降钙素原、肠道菌群失调程度、Hart腹泻计分的变化，统计痊愈率并随访1个月关注不良反应的发生。结果 与治疗前相比，粪菌移植治疗后所有患者降钙素原明显下降[（2.79±2.93）vs（0.83±0.86）ng/mL]，Hart腹泻计分明显减少[（20.40±2.62）vs（4.15±2.70）]，差异均具有统计学意义（Ps＜0.05）。治疗后患者肠道菌群失调程度明显改善（P＜0.05）。患者痊愈率达95%。治疗期间及随访1个月无不良反应发生。结论 粪菌移植可以明显改善体外循环术后患者肠道菌群失调情况及临床症状，降低患者炎症反应，且无不良事件发生，有利于患者术后康复，安全性好。

Therapeutic effect of fecal microbiota transplantation for intestinal dysbacteriosis in patients with cardiopulmonary bypass

Objective To examine the efficacy and safety of fecal microbiota transplantation（FMT）for intestinal dysbacteriosis in patients with cardiopulmonary bypass（CPB）．Methods The clinical data of 20 patients with intestinal dysbacteriosis after cardiac operation under CPB from the cardiac surgical intensive care unit（CSICU）of our hospital during January 2015 and December 2017 were collected．All the patients were given FMT．The procalcitonin levels，grades of intestinal dysbacteriosis and Hart diarrhea scores were evaluated，and the cure rate was recorded after FMT treatment．All the patients were followed up for 1 month．Results Compared with pre-FMT treatment，the patients' procalcitonin levels obviously reduced [（2.79±2.93）vs（0.83±0.86） ng/mL]，and their Hart diarrhea scores decreased significantly [（20.40±2.62）vs（4.15±2.70）] after treatment（Ps<0.05）．Significant improvement was seen in all the patients，with 19 patients were cured．No serious adverse events occurred during the treatment and follow-up．Conclusion FMT can significantly reduce the level of inflammatory response，alleviate intestinal dysbacteriosis，and reduce the occurrence of diarrhea of patients with cardiac operation under CPB with no adverse reactions．Therefore，FMT is conducive to the recovery of intestinal flora in patients with CPB．