Kasai术术后早期肠内营养对胆道闭锁患儿免疫功能及肠道菌群的影响  

Effect of Early Enteral Nutrition after Kasai Operation on Immune Function and Intestinal Flora in Children with Biliary Atresia

作　　者：符策君[1] 吴丽珍[1] 陈泽婷 林海[1] FU Cejun;WU Lizhen;CHEN Zeting;LIN Hai(Department of Pediatric Surgery,Hainan Provincial People's Hospital,Haikou,Hainan Province,570311 China)

机构地区：[1]海南省人民医院小儿外科,海南海口570311

出　　处：《中外医疗》2022年第4期8-11,共4页China & Foreign Medical Treatment

基　　金：海南省卫生健康行业科研项目(20A200029)。

摘　　要：目的探讨Kasai术术后早期肠内营养对胆道闭锁患儿免疫功能及肠道菌群的影响。方法方便选取2019年1月—2021年2月在该院接受Kasai术治疗的40例胆道闭锁患儿,随机分为常规组(n=20,给予常规肠外营养干预)和研究组(n=20,实施早期肠内营养干预)。对比两组患儿免疫功能改善情况、肠道菌群改善情况、胃肠道功能恢复情况,血红蛋白、白蛋白、前白蛋白水平及肝功能指标检查结果。结果术后7 d研究组CD3^(+)、CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+)比值分别为(53.78±4.10)%、(34.45±3.52)%、(20.15±2.68)%、(1.68±0.32),高于常规组的(50.12±3.78)%、(30.23±3.56)%、(18.03±2.51)%、(1.50±0.19),差异有统计学意义(t=2.935、3.769、2.582、2.163,P<0.05);研究组双歧杆菌、乳杆菌分别为(7.56±1.45)、(7.23±1.10),高于常规组的(6.23±1.23)、(6.34±1.11),大肠杆菌(8.78±0.78)低于常规组(9.45±0.81),差异有统计学意义(t=3.128、2.546、2.664,P<0.05);相比常规组,术后研究组肠鸣音恢复时间、肛门首次排气时间及首次排便时间更快,差异有统计学意义(P<0.05);研究组血红蛋白、白蛋白及前白蛋白水平明显优于常规组,差异有统计学意义(P<0.05);术后两组患者ALT、AST、GGT及TBil等指标均下降,但组间对比差异无统计学意义(P>0.05)。结论针对行Kasai术治疗的胆道闭锁患儿,术后早期肠内营养干预能纠正肠道菌群失衡现象,提高免疫功能,使胃肠功能尽快恢复,改善营养状况,值得推广应用。Objective To explore the effect of early enteral nutrition after Kasai operation on the immune function and intestinal flora of children with biliary atresia.Methods Conveniently selected 40 children with biliary atresia who underwent Kasai operation in the hospital from January 2019 to February 2021.They were randomly divided into a conventional group(n=20,routine parenteral nutrition intervention)and a study group(n=20,early enteral nutrition intervention).The immune function improvement,intestinal flora improvement,gastrointestinal function recovery,hemoglobin,albumin,prealbumin levels,and liver function index examination results were compared between the two groups of children.Results The CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)ratios in the study group were(53.78±4.10)%,(34.45±3.52)%,(20.15±2.68)%,(1.68±0.32)higher than those in the conventional group(50.12±3.78)%,(30.23±3.56)%,(18.03±2.51)%,(1.50±0.19)on the 7th postoperative day,the difference was statistically significant(t=2.935,3.769,2.582,2.163,P<0.05).Bifidobacterium and Lactobacillus in the study group were(7.56±1.45)and(7.23±1.10)higher than those in the conventional group(6.23±1.23)and(6.34±1.11),respectively;Escherichia coli(8.78±0.78)was lower than the conventional group(9.45±0.81),the difference was statistically significant(t=3.128,2.546,2.664,P<0.05).Compared with the conventional group,the recovery time of bowel sounds,the time of first anus exhaust,and the time of first defecation after surgery were faster in the study group,the difference was statistically significant(P<0.05).The levels of hemoglobin,albumin and prealbumin in the study group were significantly better than those in the conventional group,the difference was statistically significant(P<0.05).After the operation,the indexes of ALT,AST,GGT and TBil in the two groups were all decreased,but there was no statistically significant difference between the groups(P>0.05).Conclusion For children with biliary atresia treated by Kasai operation,early postoperative enteral

关 键 词：Kasai术 早期肠内营养 胆道闭锁 免疫功能 肠道菌群 肝功能指标 

分 类 号：R4[医药卫生—临床医学]