腹腔镜辅助经肛门Soave术对先天性巨结肠患儿肠道菌群的影响  

Impact of Laparoscopic-Assisted Transanal Soave on Intestinal Flora of Children with Congenital Megacolon

作　　者：梁煜 马春淼 周良 耿宪杰 LIANG Yu;MA Chunmiao;ZHOU Liang;GENG Xianjie(Department of General Surgery,Children's Hospital Affiliated to Zhengzhou University/Henan Provincial Children's Hospital/Zhengzhou Children's Hospital,Zhengzhou 450018,China)

机构地区：[1]郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院普通外科,河南郑州450018

出　　处：《临床医学工程》2025年第4期353-356,共4页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20200654)。

摘　　要：目的分析腹腔镜辅助经肛门Soave术对先天性巨结肠患儿肠道菌群的影响。方法选取2022年10月至2024年10月我院收治的先天性巨结肠患儿76例,随机分为观察组和对照组,各组38例。对照组予以经肛门Soave术,观察组予以腹腔镜辅助经肛门Soave术。对比两组的围术期指标、Heikkinen排便功能评分、肠道菌群(双歧杆菌、乳酸杆菌、大肠杆菌、粪肠球菌)数量、应激指标[前列腺素E2(PGE2)、β-内啡肽(β-EP)]水平、炎性因子[C-反应蛋白(CRP)、白细胞介素-6(IL-6)]水平、并发症。结果与对照组相比,观察组手术时间较长,肛门解剖时间、住院时间较短,术中出血量较低(P<0.05)。观察组排便优良率为97.37%,高于对照组的78.95%(P<0.05)。术后,观察组双歧杆菌、乳酸杆菌、粪肠球菌数量高于对照组,大肠杆菌数量低于对照组(P<0.05)。术后,观察组PGE2、β-EP、CRP、IL-6水平低于对照组(P<0.05)。观察组并发症发生率为7.89%,低于对照组的26.32%(P<0.05)。结论腹腔镜辅助经肛门Soave术治疗先天性巨结肠患儿可优化围术期指标,改善排便功能,调节肠道菌群,减轻应激反应、炎症症状,降低并发症发生率。Objective To analyze the impact of laparoscopic-assisted transanal Soave on intestinal flora of children with congenital megacolon.Methods 76 children with congenital megacolon admitted to our hospital from October 2022 to October 2024 were selected and randomly divided into the observation group and control group,with 38 cases in each group.The control group was given transanal Soave surgery,and the observation group was given laparoscopic-assisted transanal Soave surgery.The perioperative indicators,Heikkinen defecation function score,intestinal flora(bifidobacterium,lactobacillus,escherichia coli,enterococcus faecalis)counts,stress indicators[prostaglandin E_2(PGE_2),β-endorphin(β-EP)]levels,inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)]levels,and complications were compared between the two groups.Results Compcared with the control group,the surgical time of the observation group was longer,the anal dissection time and hospitalization time were shorter,and the intraoperativeblood loss was lower(P<0.05).The excellent and good rate of defecation in the observation group was 97.37%,higher than the control group of 78.95%(P<0.05).After surgery,the numbers of bifidobacterium,lactobacillus,and enterococcus faecalisin the observation group were higher than those in the control group,and the number of Escherichia coli was lower than that in the control group(P<0.05).After surgery,the PGE_2,β-EP,CRP,and IL-6 levels of the observation group were lower those in the control group(P<0.05).The incidence of complications in the observation group was 7.89%,lower than 26.32%in the control group(P<0.05).Conclusions Laparoscopic-assisted transanal Soave surgery in the treatment of children with congenital megacolon can optimize the perioperative indicators,improve the defecation function,regulate the intestinal flora,alleviate the stress reaction and inflammatory symptoms,and reduce the incidence of complications.

关 键 词：先天性巨结肠 经肛门SOAVE术 腹腔镜辅助经肛门Soave术 

分 类 号：R726.5[医药卫生—儿科]