针对性营养干预对行直肠癌根治手术患者肠道菌群、排便功能及术后并发症的影响  

Effect of Targeted Nutritional Intervention on Intestinal Flora, Defecation Function, and Postoperative Complications in Patients Who Underwent Radical Resection of Rectal Carcinoma

作　　者：高晓明[1] 郝春燕[1] 严鹏[1] 朱培华[1] 王军静[1] 陈荣[1] GAO Xiaoming;HAO Chunyan;YAN Peng;ZHU Peihua;WANG Junjing;CHEN Rong(Department of General Surgery of Second Affiliated Hospital, Xingtai Medical College, Xingtai, Hebei, 054002, China)

机构地区：[1]邢台医学高等专科学校第二附属医院普外科,河北邢台054002

出　　处：《肿瘤药学》2019年第2期338-343,共6页Anti-Tumor Pharmacy

基　　金：邢台市市级科技计划自筹经费项目(2016ZC066)

摘　　要：目的探讨针对性营养干预对行直肠癌根治手术患者肠道菌群、排便功能及术后并发症的影响。方法选取2017年1月-2018年8月于我院择期行直肠癌根治术治疗的136例患者,采用随机数字表法均分为两组。对照组给予常规肠外营养,观察组实施针对性营养干预。分别于入院时及术后7 d、1个月测定两组患者的肠道菌群参数,并于术后7 d、1个月时采用徐氏肛门直肠功能评定量表评价术后排便功能,同时统计两组术后恢复情况(包括术后排气、排便时间)及并发症发生情况。结果两组患者术后7 d的大肠杆菌、肠球菌菌落计数较入院时均明显增加(P<0.05),而双歧杆菌、乳酸杆菌菌落计数均明显减少(P<0.05),且术后1个月内逐渐恢复,其中观察组恢复至入院时水平(P>0.05),但对照组尚未恢复至入院时水平(P<0.05);观察组术后7 d、1个月时大肠杆菌、肠球菌菌落计数均显著低于对照组(P<0.05),双歧杆菌、乳酸杆菌菌落计数均显著高于对照组(P<0.05)。观察组术后7 d、1个月时的排便功能优良率分别为8.82%(6/68)、47.06%(32/68),与对照组的0(0/68)、30.88%(21/68)相比均显著上升(P<0.05)。观察组术后排气、排便及首次下床活动时间和住院时间均显著短于对照组(P<0.05)。观察组术后肺部感染、总并发症发生率分别为0%(0/68)、8.82%(6/68),较对照组的5.88%(4/68)、27.94%(19/68)均显著降低(P<0.05)。结论对行直肠癌根治术的患者实施针对性营养干预,有助于纠正其术后肠道菌群失调,促进其排便功能的恢复,减少术后并发症,效果确切。Objective To investigate the effect of targeted nutritional intervention on intestinal flora, defecation function, and postoperative complications in patients who underwent radical resection of rectal carcinoma. Methods The subjects of this study, 136 patients who received selective radical resection of rectal carcinoma in our hospital between January 2017 and August 2018, were divided into observation group(n=68) and control group(n=68) the basis of random number table. The control group was treated with routine parenteral nutrition,while the observation group with targeted nutritional intervention. The intestinal flora of the two groups were detected upon their admission and at 7 d and 30 d after operation. Their defecation function was tested by using Xu’s anorectal function evaluation scale at 7 d and 30 d after operation. Meanwhile, the recovery conditions including postoperative exhaust and defecating time, as well as complications, were recorded and compared between the two groups. Results At 7 d after operation, both groups could see increased counts of Escherichia coli and Enterococcus colonies but decreased counts of Bifidobacterium and Lactobacillus, as compared with those upon admission(P<0.05). At30 d after operation, these counts gradually restored, and those of the observation group restored to the level upon admission(P>0.05), but those of the control group did not(P<0.05). At 7 d, 30 d after operation, the observation group saw obviously less counts of Escherichia coli and Enterococcus colonies but more counts of Bifidobacterium and Lactobacillus than the control group did at identical time points(P<0.05).The good defecation rates of the observation group at 7 d and 30 d after operation were 8.82%(6/68) and 47.06%(32/68) respectively, which were much higher than those of the control group [respectively 0(0/68) and 30.88%(21/68)](P<0.05). The observation group took much shorter time for postoperative exhaust, defecation, first out-of-bed activity and shorter hospitalization than the control grou

关 键 词：针对性营养干预 直肠癌根治术 肠道菌群 排便功能 并发症 

分 类 号：R735.37[医药卫生—肿瘤]