口服微生态制剂对先天性巨结肠术后小肠结肠炎的预后影响  

Prognostic analysis of oral probiotics for Hirschsprungassociated enterocolitis

作　　者：汤成艳 郑泽兵 夏兴容 黄露 周万康 金祝 TANG Cheng-Yan;ZHENG Ze-Bing;XIA Xing-Rong(Department of Pediatric Surgery,Affiliated Hospital of Zunyi Medical University Guizhou Children's Hospital,Zunyi 563000,Guizhou,China)

机构地区：[1]遵义医科大学附属医院小儿外科贵州省儿童医院小儿外科,贵州遵义563000

出　　处：《吉林医学》2025年第2期290-293,共4页Jilin Medical Journal

基　　金：贵州省教育厅青年科技人才成长项目[项目编号:黔教技(2024)140号]。

摘　　要：目的:探讨口服微生态制剂对先天性巨结肠(HSCR)术后小肠结肠炎(HAEC)患儿的作用。方法:收集2018~2023年在遵义医科大学附属医院小儿外科住院、手术并通过病理诊断为HSCR的患儿共80例,随机分为观察组及对照组,每组40例。两组患儿术后均予抗感染、静脉营养及人工扩肛等常规治疗;另外,观察组于患儿胃肠功能恢复后予微生态制剂双歧杆菌四联活菌片治疗,随访至术后6个月,分别于术后、3个月、6个月采集患儿外周血检测血浆IL-6、降钙素原水平,分析两组患儿术后不同时间IL-6水平和降钙素原变化情况及HAEC发生率。结果:随访6个月,观察组HAEC 6例(15.0%),对照组14例(35.0%),两组差异有统计学意义(P<0.05)。观察组血浆IL-6水平低于对照组,两组血浆IL-6水平均有随时间变化的趋势,差异有统计学意义(P<0.05)。观察组血浆PCT水平低于对照组,两组血浆PCT水平均有随时间变化的趋势,差异有统计学意义(P<0.05)。结论:微生态制剂的使用对HSCR术后患儿可能是一种保护因素,能降低促炎因子IL-6、PCT水平,从而减少HAEC的发生。Objective To explore the effect of oral probiotics on postoperative Hirschsprung associated enterocolitis(HAEC)in children with congenital megacolon disease(HSCR).Method Collect data from 2018 to 2023 in the Department of Pediatric Surgery,Affiliated Hospital of Zunyi Medical University.A total of 80 children who were hospitalized,surgically diagnosed with HSCR through pathological examination were randomly divided into an observation group and a control group,with 40 cases in each group.Both groups of patients received routine treatments such as anti infection,intravenous nutrition,and artificial anal dilation after surgery.In addition,the observation group received probiotic Bifidobacterium quadruplex live bacterial tablets after the recovery of gastrointestinal function in the affected children.Follow up until 6 months postoperatively,and collect peripheral blood from the patient at postoperative,3 months,and 6 months to detect plasma IL-6 and procalcitonin levels.Analyze the changes in IL-6 levels and procalcitonin levels at different postoperative times and the incidence of HAEC in two groups of pediatric patients.Results After a 6-month follow-up,there were 6 cases of HAEC in the observation group(15.0%)and 14 cases in the control group(35.0%),the difference between the two groups was statistically significant(P<0.05).The plasma IL-6 levels in the observation group were lower than those in the control group,and the average plasma IL-6 levels in both groups showed a trend of change over time(P<0.05).The plasma PCT levels in the observation group were lower than those in the control group,and both groups showed a trend of changes in plasma PCT levels over time(P<0.05).Conclusion The use of probiotics may be a protective factor for children after HSCR surgery,as it can reduce the levels of pro-inflammatory factors IL-6 and PCT,thereby reducing the occurrence of HAEC.

关 键 词：先天性巨结肠 小肠结肠炎 微生态制剂 预后 

分 类 号：R574.6[医药卫生—消化系统]