CAJ | 학술논문

目的：评价肠道微生态制剂（ microbio ecological preparation, MBP)在胆肠吻合术围术期的应用效果及安全性。方法选择2011年3月—2014年3月解放军180医院普通外科收治的拟行胆肠吻合术的67例作为研究对象,按照随机数字表法随机将其分为观察组（34例)和对照组（33例)。对照组围术期给予常规干预措施。观察组围术期在常规干预措施基础上给予肠道MBP。观察比较两组术前5 d与术后2周肠道菌群计数变化情况、术后恢复情况、术后感染相关指标恢复正常时间、术后抗生素使用时间及术后并发症发生率、病死率,并记录两组围术期不良反应发生情况。结果术后2周,观察组双歧杆菌、乳酸杆菌、肠球菌、总菌落计数均较术前5d明显提高,对照组双歧杆菌、乳酸杆菌、肠球菌计数均较术前5d明显降低,观察组双歧杆菌、乳酸杆菌及肠球菌计数均显著高于对照组,差异均具有统计学意义（P<0．05)。观察组术后排气时间、排便时间、住院天数及术后感染相关指标恢复正常时间、抗生素使用时间均较对照组缩短,差异均具有统计学意义（ P<0．05)。两组术后并发症发生率及病死率比较差异无统计学意义（P>0．05)。两组围术期均未发生明显不良反应。结论在胆肠吻合术围术期应用肠道MBP能够调整肠道菌群、促进术后恢复、缩短病程、降低感染概率,且安全性较好。
목적：평개장도미생태제제（ microbio ecological preparation, MBP)재담장문합술위술기적응용효과급안전성。방법선택2011년3월—2014년3월해방군180의원보통외과수치적의행담장문합술적67례작위연구대상,안조수궤수자표법수궤장기분위관찰조（34례)화대조조（33례)。대조조위술기급여상규간예조시。관찰조위술기재상규간예조시기출상급여장도MBP。관찰비교량조술전5 d여술후2주장도균군계수변화정황、술후회복정황、술후감염상관지표회복정상시간、술후항생소사용시간급술후병발증발생솔、병사솔,병기록량조위술기불량반응발생정황。결과술후2주,관찰조쌍기간균、유산간균、장구균、총균락계수균교술전5d명현제고,대조조쌍기간균、유산간균、장구균계수균교술전5d명현강저,관찰조쌍기간균、유산간균급장구균계수균현저고우대조조,차이균구유통계학의의（P<0．05)。관찰조술후배기시간、배편시간、주원천수급술후감염상관지표회복정상시간、항생소사용시간균교대조조축단,차이균구유통계학의의（ P<0．05)。량조술후병발증발생솔급병사솔비교차이무통계학의의（P>0．05)。량조위술기균미발생명현불량반응。결론재담장문합술위술기응용장도MBP능구조정장도균군、촉진술후회복、축단병정、강저감염개솔,차안전성교호。
Objective To investigate the application effect and the safety evaluation of microbio ecological prepara-tion ( MBP) in biliary intestinal anastomosis during perioperative period. Methods 67 patients admitted during March 2011 and March 2014 were chosen as research subjects. They were to undergo anastomosis. According to random number table method, the patients were randomly divided into observation group (34 cases) and control group (33 cases). The control group was given perioperative conventional interventions. Perioperative observation group, based on the treatment of conven-tional interventions, was given for intestinal MBP. The variation of gut bacteria counts, recovery condition after operation, the time of postoperative infection related index returning to normal, postoperative antibiotic consumption time, the incidence of complications and case fatality rate after operation of the two group 5 days before operation and 2 weeks after operation were ob-served. Perioperative adverse reactions of the two groups were also recorded. Results Bifidbacterium, lactobacillus, entero-coccus, total colony counts improved more significantly 2 weeks after operation than that 5 days before operation in observation group. In control group, bifidobacterium, lactobacillus, enterococcus counts were significantly lower than that 5 days before operation. In observation group, bifidobacterium, lactobacillus and enterococcus counts were significantly higher than that of the control group. The differences were statistically significant (P<0. 05). The exhaust time after operation, defecation time, hospitalization time, the time of postoperative infection related index returning to normal, antibiotics consumption time of ob-servation group were shorter than that of the control group. The differences were statistically significant (P<0. 05). The inci-dence rate of complications and case fatality rate after operation of the two groups were compared. There were no statistically significant differences (P>0. 05). During perioperative period, no obvious adverse reaction occurred in the two groups. Con-clusion In the bile of intestinal anastomosis, perioperative application of MBP can adjust the intestinal flora, promote postop-erative recovery, shorten the course of the disease, with better safety and a lower rate of infection.