益生菌对胆道闭锁术后胆管炎预防作用的前瞻对照研究  

A prospective controlled trial of probiotics on cholangitis after Kasai procedure for biliary atresia

作　　者：郑帅玉[1] 韦佳[1] 翁一珍[1] 冯杰雄[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院小儿外科,武汉430030

出　　处：《中华小儿外科杂志》2012年第4期268-271,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨益生菌对胆道闭锁（biliatyatresia，BA）术后胆管炎的预防作用。方法采用前瞻、随机、对照的研究方法，对60例获得知情同意的Ⅲ型BA术后患儿按照手术后是否辅以益生菌治疗随机分为实验组（30例）和对照组（30例）。测定患儿血清总胆红素（TB）、直接胆红素（DB）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）水平，结合术后胆汁排出率和随访获得的黄疽消退率及胆管炎发生率综合评定益生菌对胆道闭锁术后胆管炎的预防作用。结果实验组和对照组患儿平均手术年龄为（52．75±34．30）d和（55．87±29．23）d，手术前各项血生化指标TB（131．49±41．40）umol／L和（120．16±47．68）umol／L、ALT（161．01±30．06）umol／L和（150．21±36．24）umol／L经统计学分析差异均无统计学意义（P〉0．05），术后2周时两组胆汁排出率为93．3％和90．0％，差异无统计学意义（P〉0．05）。随访结果表明术后3个月、6个月时实验组与对照组的胆管炎发生率为58．6％和62．1％、52．0%和54．2％，疗效指标差异均无统计学意义（P〉0．05）。结论益生菌对胆道闭锁术后胆管炎的发生无明显预防作用。Objective To evaluate the preventive effect of probiotics on cholangitis after Kasai procedure for biliary atresia （BA）. Methods It was a prospective, randomized and controlled clinical trial. Sixty children with BA who underwent Kasai procedure were obtained informed consent and enrolled into this study. Children who were treated with probiotics were selected as the experimental group （30 cases）, and those who didn＇t had probiotics were taken as controls （30 cases）. The diagnose of BA was confirmed by operation and pathological examination. The data of jaundice extinction ratio and incidence of cholangitis were obtained during follow-up. Results There were no statistical differences either in length of operation age [（52.75 ± 34. 30）d vs. （55.87 ± 29. 23）d] or in biochemical indicators [TB（131.49 ± 41.40）umol/Lvs. （120. 16 ± 47. 68）umol/L,ALT（161.01 ± 30. 06）umol/Lvs. （150. 21 ± 36. 24）umol/L] between the 2 groups （P〉0. 05）. No statistical differences of jaundice extinction ratio （93.3% vs. 90.0% ） and biochemical indicators were found 2 weeks after operation between the 2 groups （P〉0. 05）. There were no statistical differences of biochemical indicators and the incidence of cholangitis between the 2 groups 3 months and 6 months after operation [58.6% vs. 62. 1%.52. 0%vs. 54. 2% （P〉0. 05）]. Conclusions Probiotics may have no preventive effects on cholangitis after Kasai procedure for biliary atresia.

关 键 词：胆管炎 胆道闭锁 

分 类 号：R726.5[医药卫生—儿科]