结直肠息肉切除术患者肠道微生态失调分析及其与癌变进展的相关性  

Intestinal microecological imbalance in patients with colorectal polypectomy and its correlation with cancerization

作　　者：王晓明 陈茜 吕金锋 张攀攀 WANG Xiaoming;CHEN Qian;LYU Jinfeng;ZHANG Panpan(General Surgery Department,Henan Jiaozuo Coal Industry(Group)Co.,Ltd.Central Hospital,Jiaozuo,Henan 454000,China;不详)

机构地区：[1]河南省焦作煤业(集团)有限责任公司中央医院普外二科,河南焦作454000

出　　处：《中国微生态学杂志》2020年第10期1199-1202,共4页Chinese Journal of Microecology

摘　　要：目的分析结直肠息肉切除术患者肠道微生态失调情况及其与癌变进展的相关性。方法前瞻性选择2015年7月至2016年7月在我院行结直肠息肉切除术的89例患者为研究对象,评价所有研究对象手术前后肠道菌群计数、肠道菌群失调情况,采用单因素和多因素Logistic回归分析结直肠息肉切除术患者癌变的影响因素。结果结直肠息肉患者术后大肠埃希菌计数(10.85±0.50)、粪肠球菌计数(10.12±0.55)显著高于术前(8.34±0.41,7.76±0.37)(均P<0.01),结直肠息肉患者术后双歧杆菌计数(2.56±0.68)、乳杆菌计数(2.83±0.71)显著低于术前(5.20±1.06,5.93±0.88)(均P<0.01)。结直肠息肉患者术后Ⅰ度菌群失调比例(23.60%)显著低于术前(55.06%)(P<0.05),结直肠息肉患者术后Ⅱ、Ⅲ度菌群失调比例(50.56%,25.84%)显著高于术前(34.83%,10.11%)(均P<0.05)。随访3年显示89例结直肠息肉切除术患者癌变率为33.71%,性别、病理类型不同的结直肠息肉切除术患者癌变率差异无统计学意义(均P>0.05),年龄、遗传史、息肉直径、肠道菌群失调程度不同的结直肠息肉切除术患者癌变率差异具有统计学意义(均P<0.05)。年龄、遗传史、肠道菌群失调程度是结直肠息肉切除术患者癌变的影响因素(均P<0.05)。结论结直肠息肉切除术患者存在明显肠道微生态失调情况,肠道微生态失调是结直肠息肉切除术患者癌变的危险因素,这对临床防治结直肠息肉切除术患者癌变有重要指导意义。Objective To observe intestinal microecological imbalance in patients with colorectal polypectomy and its correlation with cancerization.Methods A total of 89 patients who underwent colorectal polypectomy in our hospital from July 2015 to July 2016 were prospectively selected.The intestinal flora counts and intestinal flora imbalance before and after operation were recorded,then the influencing factors of cancerization in these patients were determined by using single factor and multi-factor logistic regression analyses.Results After operation,the counts of Escherichia coli[pre/post:(8.34±0.41)vs(10.88±0.50)]and Enterococcus faecalis[pre/post:(7.76±0.37)vs(10.12±0.55)]in patients with colorectal polyps increased(P<0.01),and the counts of Bifidobacteria[pre/post:(5.20±1.06)vs(2.56±0.68)]and Lactobacillus[pre/post:(5.93±0.88)vs(2.83±0.71)]decreased(P<0.01).The proportion of degree I flora imbalance(pre/post:55.06%vs 23.60%)was decreased after operation,meanwhile,the proportion of degree II(pre/post:34.83%vs 50.56%)and III flora imbalance(pre/post:10.11%vs 25.84%)were increased(P<0.05).There years follow-up results showed that the cancer rate of 89 patients with colorectal polypectomy was 33.71%.The cancer rate showed no difference between patients with different gender and pathological types(P>0.05),while had statistic difference among patients with different age,genetic history and intestinal flora imbalance degrees(P<0.05).Age,genetic history and degree of intestinal flora imbalance were the influencing factors of canceration in patients undergoing colorectal polypectomy(P<0.05).Conclusion Intestinal microecological imbalance often occurs among patients with colorectal polypectomy have obvious,as a risk factor for cancerization,which has important guiding significance for clinical prevention and treatment of canceration in patients undergoing colorectal polypectomy.

关 键 词：结直肠息肉切除术 肠道微生态失调 癌变 相关性 

分 类 号：R604[医药卫生—外科学]