CAJ | 학술논문

目的比较传统肠道准备与快速肠道准备对结直肠癌患者术后肠道菌群变化的影响.方法前瞻性入组2010年3月至2011年3月间南方医科大学南方医院收治的60例结直肠癌患者,按抓阄的方法随机分成试验组(33例,术前仅行1d的肠道准备)和对照组(27例,按传统的3d方案进行肠道准备).分别于肠道准备前和术后第1次排粪时,留取粪便进行肠道菌群分析,并观察术后肠道菌群紊乱及感染性并发症的发生情况.结果两组患者术后均发生不同程度的肠道菌群失调,表现为双歧杆菌、乳酸杆菌等益生菌种计数较术前明显减少(P＜0.05),且对照组较试验组下降更明显(P＜0.05);而大肠杆菌、葡萄球菌等致病菌的计数则明显高于术前(P＜0.05),且对照组明显高于试验组(P＜0.05).试验组术后感染性并发症发生率为9.1％(3/33),明显低于对照组的29.6％( 8/27)(P＜0.05).结论快速肠道准备在一定程度上可减轻术后肠道菌群的紊乱程度,并降低术后感染性并发症的发生率.
목적 비교전통장도준비여쾌속장도준비대결직장암환자술후장도균군변화적영향.방법 전첨성입조2010년3월지2011년3월간남방의과대학남방의원수치적60례결직장암환자,안조구적방법수궤분성시험조(33례,술전부행1d적장도준비)화대조조(27례,안전통적3d방안진행장도준비).분별우장도준비전화술후제1차배분시,류취분편진행장도균군분석,병관찰술후장도균군문란급감염성병발증적발생정황.결과 량조환자술후균발생불동정도적장도균군실조,표현위쌍기간균、유산간균등익생균충계수교술전명현감소(P＜0.05),차대조조교시험조하강경명현(P＜0.05);이대장간균、포도구균등치병균적계수칙명현고우술전(P＜0.05),차대조조명현고우시험조(P＜0.05).시험조술후감염성병발증발생솔위9.1％(3/33),명현저우대조조적29.6％( 8/27)(P＜0.05).결론 쾌속장도준비재일정정도상가감경술후장도균군적문란정도,병강저술후감염성병발증적발생솔.
Objective To comparc thc impact of traditional and fast bowel preparation on the changes of gut flora in the patients following colorectal resection.Methods Sixty patients undergoing colorectal resection from March 2010 to March 2011 in the Nanfang Hospital were randomly divided into the control group (n=27,3 days of bowel preparation) and the experimental group (n=33,1 day of bowel preparation).Fresh feces were collected before bowel preparation and on the first defecation after surgery.The postoperative changes in gut flora and septic complications were observed.Results Gut flora disturbance was found in both groups.The postoperative population of Bifidobacterium and Lactobacillus decreased significantly(P＜0.05),and the decrease was more significant in the experimental group compared to the control group (P＜0.05),while E.coli and Staphylococcus were much higher than the preoperative level (P＜0.05),which was more significant in the control group.The incidence of postoperative infection was 9.1％ (3/33) in the experimental group,which was significantly lower than 29.6％(8/27) in the control group (P＜0.05).Conclusion Fast bowel preparation is effective in reducing gut flora disturbance and the incidence of postoperative infection.