肠道菌群移植外科临床应用的争议与共识  

Controversy and consensus on the clinical application of Fecal microbiota transplantation in surgery

作　　者：秦环龙[1,2,3] 方芷珣 陈启仪 田宏亮 QIN Huan-long;FANG Zhi-xun;CHEN Qi-yi(Colorectal Disease Department of Tenth People's Hospital Affiliated Tongji University,Shanghai200072,China;不详)

机构地区：[1]同济大学附属第十人民医院结直肠病专科,上海200072 [2]同济大学附属第十人民医院肠道微生态治疗中心,上海200072 [3]上海人体肠道菌群功能开发工程技术研究中心,上海200072 [4]同济大学医学院,上海200072

出　　处：《中国实用外科杂志》2024年第2期159-163,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金项目(No.82100698);同济大学附属第十人民医院攀登人才计划项目(2021SYPDRC045)。

摘　　要：肠道菌群移植(FMT)是指将健康人粪便中的功能菌群经一定的方式移植到病人的肠道内,从而调控肠道微生态平衡、重建肠道菌群,达到预防和治疗肠道内外疾病的目的。近年来,FMT治疗病种从复发性难辨梭状芽孢杆菌感染(rCDI)扩展至炎症性肠病(IBD)、肠易激综合征(IBS)、慢性便秘及其他疾病,FMT治疗领域也从内科、儿科延伸到外科。目前有限的临床研究结果显示,外科围手术期应用FMT可能会提高手术病人治愈率,减少术后并发症以及提高术后营养状况和生活质量。但由于FMT在外科领域研究时间尚短,缺乏大样本高质量临床研究,同时,FMT本身方法学较为复杂且存在诸如供体选择、粪便样本标准化处理、FMT移植途径建立等方法学问题仍待完善。因此,对于在外科围手术期应用FMT的具体治疗策略以及疗效尚需要更多更高级别证据加以验证和进一步深入探讨。Fecal microbiota transplantation(FMT) refers to the transplantation of functional microbiota from healthy human feces into the patient's intestines in a certain way,to regulate the balance of gut microbiota,rebuilding gut microbiota,and achieve the goal of preventing and treating internal and external intestinal diseases.In recent years,FMT treatment has expanded from recurrent Clostridioides difficile infection(rCDI) to inflammatory bowel disease(IBD),irritable bowel syndrome(IBS),chronic constipation,and other diseases.The field of FMT treatment has also extended from internal medicine and pediatrics to surgery.Multiple clinical studies have shown that the application of FMT during the perioperative period can improve the cure rate of surgical patients,reduce postoperative complications,and improve postoperative nutritional status and quality of life.However,due to the short duration of FMT surgical research and the lack of high-quality clinical studies with large samples,the methodology of FMT itself is complex and there are methodological issues such as donor selection,standardized treatment of fecal samples,and establishment of FMT transplantation pathways that need to be improved.Further research and discussion are needed on the specific treatment plan and efficacy of FMT applied in the perioperative period of surgery.

关 键 词：菌群移植 微生态 粪便 

分 类 号：R6[医药卫生—外科学]