维持肠内菌群稳定预防结直肠癌患者术后并发症的效果分析  

A Study on Protection Effects of Stabilizing Intestinal Flora from Postoperative Complications for Colorectal Cancer Patients

作　　者：李东正[1] 周建农[1] 杨柳[1] 周欣[1] 王东风[1] 余东升[1] LI Dongzheng ZHOU Jiannong YANG Liu ZHOU Xin WANG Dongfeng YU Dongsheng(Department of General Surgery, Jiangsu Cancer Hospital, Nanjing, Jiangsu, 210000, China)

机构地区：[1]江苏省肿瘤医院普通外科,江苏南京210000

出　　处：《肿瘤药学》2016年第6期428-432,共5页Anti-Tumor Pharmacy

摘　　要：目的探讨维持肠内菌群稳定在预防结直肠癌手术患者术后并发症中的应用价值。方法选取2014年6月～2016年6月我院结直肠外科收治的82例结直肠癌手术患者作为研究对象，采用随机数字表法分为两组，每组41例。两组患者在术前给予不同的肠道准备方案：对照组患者入院后开始应用乳果糖口服溶液，术前3天饮食以半流食为主，术前1天改为全流食，术前3天给予庆大霉素和甲硝唑，术前1天及手术当天清晨分别进行清洁灌肠处理；观察组患者术前1天口服聚乙二醇电解质溶液，术前3天饮食以半流食为主，术前1天改为全流食，术前3天口服双歧杆菌四联活菌片，不口服任何抗菌药物，术前1天及手术当天清晨不给予机械式灌肠处理。比较两组患者的临床疗效、术后并发症的发生情况及治疗前后生存质量情况。结果观察组临床疗效（95．12％）明显优于对照组（73．17％），差异有统计学意义（P〈0．05）；观察组患者手术后Ⅲ度肠道菌群比例失调的比例（4．88％）明显低于对照组（24．39％），差异有统计学意义（P〈0．05）；观察组患者手术后并发症发生率（17．07％）明显低于对照组（53．66％），差异有统计学意义（P〈0．05）；两组患者手术后KPS功能状况评分及BMI指数情况均优于手术前，差异有统计学意义（P〈0．05）；观察组患者KPS功能状况评分（73．10±18．34）及BMI指数（21．65±6．88）kg·m^-2明显优于对照组[（64．01±16．67），（16．78±4．21）kg·m^-2]，且较治疗前稳定性更为良好，差异有统计学意义（P〈0．05）。结论对结直肠癌手术患者治疗期间通过有效的术前准备及治疗来维持患者肠内菌群稳定，能够有效预防术后并发症的发生，并有效改善患者生存质量。Objective To study the effect of maintaining the stability of the intestinal flora on preventing colorectal cancer patients from postoperative complications. Methods 74 patients diagnosed as colorectal cancer were included in this study from Jim., 2014 to Jun., 2016. All patients were randomly divided into control group and observation group, 37 cases in each group. Patients of the two groups were given different bowel preparation programs before surgery. The control group dealt with traditional process. They were given lactulose oral solution, semi-fluid diet for three days before operation and liquid diet for the operation day. Gentamicin and metronidazole were given for three days before operation. The patients were treated with cleansing enema on one day before and the early morning of operation. While patients in the observation group were given oral polyethylene glycol electrolyte solution the day before operation, semi-fluid diet for three days before operation and liquid diet for the operation day. They were given oral bifidobacterium tetravaccine tablets for three days before operation. The occurrence of postoperative complications and quality of life of patients before and after treatment were compared between the two groups. Results The protection effect from postoperative complications of the observation group （95.12%） was significantly better than that of the control group （73.17%）, and the difference was statistically significant （P〈0.05）. Ratio of degree Ⅲ of intestinal flora imbalance （4.88%） in the observation group was significantly lower than that （24.39%） in the control group （P 〈 0.05）. The incidence of postoperative complications （17.07%） in the observation group was significantly lower than that （53.66%） in the control group （P〈 0.05）. The KPS score and BMI index in the observation group was significantly better than that in the control group （P〈0.05）. Conclusion Corresponding preoperative preparation and treatment for stabilizing intestinal

关 键 词：维持肠内菌群稳定 预防 结直肠癌 术后并发症 

分 类 号：R735.1[医药卫生—肿瘤]