肠道菌群干预在日间腹腔镜胆囊切除术加速康复外科中的临床研究  

Clinical study of intestinal flora intervention in enhanced recovery affer surgery during daytime laparoscopic cholecystectomy

作　　者：陈伟力[1] 方宁波[1] 阮丽琴 欧阳霆[1] 刘合春[1] CHEN Weili;FANG Ningbo;RUAN Liqin;OUYANG Ting;LIU Hechun(Department of Hepatobiliary Surgery,Jiujiang NO.1 People's Hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院肝胆胰外一科,江西九江332000

出　　处：《当代医学》2024年第16期90-94,共5页Contemporary Medicine

基　　金：江西省卫生健康委科技计划(202311429)。

摘　　要：目的探讨肠道菌群干预在日间腹腔镜胆囊切除术(day-care laparo-scopic cholecystectomy,DCLC)加速康复外科(enhanced recovery affer surgery,ERAS)中的临床疗效。方法选取2020年1月至2022年12月在九江市第一人民医院肝胆胰外科接受DCLC的60例患者作为研究对象,按照随机数字表法分为对照组、研究A组与研究B组,每组20例。所有患者均行DCLC,对照组采用常规的ERAS围手术期治疗,研究A组在对照组基础上联合肠道菌群,研究B组在研究A组基础上联合口服维生素D3。比较3组临床指标(腹泻发生率、胃肠道紊乱发生率、延迟出院率、再入院率),治疗前后血清D-乳酸、胃泌素水平及不良反应发生率。结果研究A组与研究B组腹泻发生率、胃肠道紊乱发生率、延迟出院率、再入院率均低于对照组,差异有统计学意义(P<0.05)。治疗后,3组血清D-乳酸及研究A组胃泌素水平均低于治疗前,研究A组、研究B组血清D-乳酸水平均低于对照组,且研究B组低于研究A组,差异有统计学意义(P<0.05)。3组并发症发生率比较差异无统计意义。结论肠道菌群干预能提高行DCLC ERAS患者的胃肠功能恢复,可减少腹泻、胃肠道紊乱的发生,降低延迟出院率和再入院率,有利于患者快速康复。Objective To investigate the clinical efficacy of intestinal flora intervention in enhanced recovery affer surgery(ERAS)during day-care laparoscopic cholecystectomy(DCLC).Methods 60 patients receiving DCLC in the department of Hepatobiliary and Pancreatic Surgery of the Jiujiang NO.1 People's Hospital from January 2020 to December 2022 were selected as the study subjects,and they were divided into the control group,study group A and study group B according to random number table method,with 20 cases in each group.All patients received DCLC,and the control group received conventional ERAS perioperative treatment,the study group A was combined with intestinal flora on the basis of the control group,and the study group B was combined with oral vitamin D3 on the basis of the study group A.The clinical indicators(incidence of diarrhea,gastro-intestinal disorders,delayed discharge rate,readhospital rate),serum levels of D-lactic acid and gastrin before and after treatment,and the total inci-dence of adverse reactions were compared among the three groups.Results The incidence of diarrhea,gastrointestinal disorders,delayed discharge rate and readmitted rate of study group A and study group B were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,serum D-lactic acid levels in the three groups and gastrin levels in the study group A were lower than before treatment,se-rum D-lactic acid levels in the study group A and the study group B were lower than that in the control group,and the study group B was lower than study group A,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of complications among the three groups.Conclusion Intestinal flora intervention can improve the recovery of gastrointestinal function in patients with DCLC ERAS,reduce the occurrence of diarrhea and gastrointestinal disorders,and reduce the rate of delayed discharge and readmission,which is conducive to rapid recovery of patie

关 键 词：日间腹腔镜胆囊切除术 肠道菌群干预 术后腹泻 胃肠道紊乱 加速康复外科 维生素D3 

分 类 号：R657.4[医药卫生—外科学]