腹腔镜下胆囊手术患者围术期抗生素暴露对患者肠道菌群结构和肠黏膜免疫平衡的影响  

Effect of Perioperative Antibiotic Exposure on the Structure of Intestinal Flora and Immune Balance of Intestinal Mucosa in Patients Undergoing Laparoscopic Gallbladder Surgery

作　　者：郭文博 赵长海[1] GUO Wenbo;ZHAO Changhai(Department of General Surgery,Jiamusi Central Hospital,Jiamusi 154002,Heilongjiang,China)

机构地区：[1]佳木斯市中心医院普外一科,黑龙江佳木斯154002

出　　处：《中国药物滥用防治杂志》2023年第5期823-827,共5页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：黑龙江省卫生健康委员会项目(编号:2019-352)。

摘　　要：目的:探讨腹腔镜下胆囊手术患者围术期抗生素暴露对患者肠道菌群结构和肠黏膜免疫平衡的影响.方法:选取2018年8月—2021年8月于我院接受腹腔镜下胆囊手术患者80例为研究对象,按照随机数字表法分为观察组和对照组,每组40例.对照组术前给予静脉滴注头孢呋辛,观察组术前给予静脉滴注头孢呋辛且术后72h内持续用药.比较两组术后感染率、临床观察指标、肠道菌群变化情况以及D-乳酸(D-lactic acid,D-LC)、细菌内毒素(endotoxin,BT)、二胺氧化酶(diamine oxidase,DAO)含量.结果:观察组术后感染率为2.50%,低于对照组的20.00%(P<0.05);观察组术后体温恢复正常时间、PCT恢复正常时间、血象恢复正常时间、术后平均住院时间短于对照组(P<0.05);观察组乳杆菌、双歧杆菌、肠杆菌及肠球菌数量均少于对照组(P<0.05);观察组D-LC、BT、DAO含量高于对照组(P<0.05).结论:腹腔镜下胆囊手术患者围术期抗生素暴露可降低感染率,改善临床指标,具有临床应用意义.Objective:To investigate the effect of perioperative antibiotic exposure on the structure of intestinal flora and immune balance of intestinal mucosa in patients undergoing laparoscopic gallbladder surgery.Methods:A total of 80 patients who underwent laparoscopic gallbladder surgery in our hospital from August 2018 to August 2021 were selected as the research objects.The patients were randomly divided into an observation group and a control group,with 40 cases in each group.The control group was given intravenous cefuroxime before operation;the observation group was given intravenous cefuroxime before operation,and continued medication within 72 hours after operation.The postoperative infection rate,clinical observation indexes,changes of intestinal flora,and contents of D-lactic acid(D-LC),bacterial endotoxin(BT),and diamine oxidase(DAO)were compared between the two groups.Results:The postoperative infection rate of the observation group was 2.50%,which was lower than 20.00%of the control group(P<0.05).The postoperative body temperature recovery time,PCT recovery time,blood image recovery time and postoperative average hospitalization time in the observation group were shorter than those in the control group(P<0.05).The number of Lactobacillus,Bifidobacterium,Enterobacter and Enterococcus in the observation group was less than that in the control group(P<0.05).The contents of D-LC,BT and DAO in the observation group were higher than those in the control group(P<0.05).Conclusion:Perioperative antibiotic exposure in patients with laparoscopic gallbladder surgery can reduce the infection rate and improve clinical indicators,which has clinical significance.

关 键 词：腹腔镜下胆囊手术 抗生素暴露 肠道菌群结构 肠黏膜免疫平衡 

分 类 号：R657.4[医药卫生—外科学]