补充双歧三联活菌对大肠癌术后肠道菌群的影响  

Effects of bifid triple viable supplement on intestinal flora in patients undergoing colorectal cancer resection

作　　者：张纪伟[1] 杜鹏[1] 杨宝仁[1] 崔龙[1] 应春妹[2] 

机构地区：[1]上海交通大学医学院新华医院肛肠外科,上海200092 [2]上海交通大学医学院仁济医院检验科,上海200127

出　　处：《上海交通大学学报（医学版）》2008年第10期1285-1287,1300,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市卫生局基金(2006045)~~

摘　　要：目的探讨术前补充双歧三联活菌对大肠癌术后肠道菌群的影响。方法60例大肠癌患者随机分为治疗组和对照组,治疗组术前口服双歧三联活菌。术前及术后分别留取粪便作肠道菌群分析、血细菌培养、血浆内毒素含量检测,观察术后感染并发症。结果对照组术前粪便中双歧杆菌/大肠杆菌的计数比值(B/E)倒置,术后大肠杆菌计数明显增加(P<0.05),双歧杆菌计数则明显减少(P<0.05),B/E较术前倒置更为明显(P<0.05)。治疗组术前粪便中B/E>10,术后大肠杆菌计数无明显增加(P>0.05),双歧杆菌计数则明显减少(P<0.05),B/E下降(P<0.05),但仍大于1。两组真菌计数变化不明显(P>0.05)。对照组术后血浆内毒素含量较术前显著增加(P<0.05),治疗组术后无明显增加(P>0.05)。所有病例术前血细菌培养均为阴性。治疗组术后血细菌培养阳性率和感染性并发症发生率分别为3.3%和10.0%,对照组分别为20.0%和33.3%,两组差异均有统计学意义(P<0.05)。结论术前补充双歧三联活菌能改善大肠癌患者术前出现的肠道菌群失调,有助于术后重建肠道菌群平衡,减少术后感染并发症。Objective To investigate the effects of bifid triple viable supplement before operation on intestinal flora in patients undergoing colorectal cancer resection. Methods Sixty patients with coloreetal cancer were randomly grouped into experiment group and control group. Bifid triple viable was orally administered to those in the experiment group. Before and after operation, the stools of the two groups were subject to intestinal flora analysis, blood bacterial cultivation was carried out, detection of the content of plasma endotoxin was conducted, and the postoperative complications were observed. Results Preoperative BiJTdobacterium/E. coli（B/E） ratio was reversed in control group. After operation, the quantity of E. coli was much higher than that before operation （ P 〈 0.05） , while Bifidobacterium decreased significantly （ P 〉 0.05） , and B/E ratio was more significantly reversed （P 〈 0.05）. Preoperative B/E ratio was more than 10 in experiment group. After operation, there was no significant increase in the quantity of E. coli, while that of Bifidobacterium significantly decreased （ P 〈 0.05）, and B/E ratio decreased （ P 〈 0.05 ）, but still more than 1. There was no significant changes in the quantity of fungus for both groups （ P 〉 0.05）. Postoperative content of endotoxin in plasma increased significantly in control group （P 〈 0.05） , while not in experiment group （ P 〉 0.05）. Blood bacterial cultivation was negative in all the patients before operation. After operation, the positive rate of blood bacterial cultivation and the incidence of infective complications in experiment group were 3. 3% and 10. 0% , respectively, while those in control group were 20. 0% and 33. 3% , respectively. There were significant differences between the two groups （ P 〈 0.05）. Conclusion Supplement of bifid triple viable before operation can improve dysbacteriosis, reconstruct the balance of intestinal flora and reduce the infective complications after operation in patient

关 键 词：大肠肿瘤 肠道准备 细菌易位 内毒素类 厌氧菌 双歧杆菌 

分 类 号：R735.34[医药卫生—肿瘤]