结直肠癌术前vivonex替代肠道准备的临床研究  

Clinical study of preoperative bowe l preparation with vivonex in colorectal cancer

作　　者：吴承堂[1] 黄祥成[1] 杨希山[2] 谭建美[1] 甄莉[1] 张秀荣[2] 孙勇[2] 

机构地区：[1]第一军医大学南方医院普通外科,广州510515 [2]第一军医大学南方医院消化科,广州510515

出　　处：《中华胃肠外科杂志》2003年第3期184-186,共3页Chinese Journal of Gastrointestinal Surgery

基　　金：广东省重点科技攻关项目(2002C31004)

摘　　要：目的探讨口服vivonex可否替代结直肠癌术前肠道准备。方法结直肠癌患者40例,分vivonex组(20例)和对照组(20例),手术前后行肠道菌群分析,血浆D-乳酸、血中细菌DNA检测,观察术中肠道清洁情况和术后感染性并发症的发生率。结果两组术前双歧杆菌/大肠杆菌(B/E)比值倒置,对照组术后B/E比值(0.25±0.06)较术前(0.72±0.59)倒置更为明显,P<0.01。vivonex组术后B/E比值(1.36±0.34)较术前(0.76±0.47)显著增加,P<0.05;两组术后B/E比值比较,vivonex组较对照组显著增加(P<0.01)。术后血浆D-乳酸对照组较vivonex组显著增加(P<0.05),血中DNA阳性率(40%)、术后感染性并发症发生率(25%)对照组均高于vivonex组(25%和15%)。结论vivonex用于结直肠癌术前肠道准备可维护肠屏障功能,降低术后感染性并发症发生率。Objective To investigate the probability of bowel preparation with vivonex replac ement for traditional methods in colorectal cancer.Methods Fourty patients with colorectal can cers were divided into two groups.Vivonex group(n=20)received bowel preoperative preparation with vivonex and control group received traditional bowel pr eparation.The preoperative and postoperative changes of intestinal flora,levels of plasma D-lactate,bacterial DNA in blood,cleaning degree of in testine and postoperative infectio us complication were studied respectively.Results Preoperative bifidobacterium /E.c oli(B /E)ratio was reversed in the two groups.Compared with preoperative B /E ratio,postop erative B /E reversal ratio decreased significantly in the cont rol group(0.25±0.06vs 0.72±0.59,P<0.01),while increased significantly in vivonex group(1.36±0.34vs 0.76±0.46,P<0.05).Postoperative B /E ratio in vivonex group was much higher than that in the control group(P<0.01).Plasma D-lactate in the control gro up was much higher than that in vivonex grou p(P<0.05).The positive rate of bacterial DNA i n blood and postoperative morbidity rate in viv onex group decreased significantly compared with those in the control group(25%vs 40%,15%vs 25%respectively).Conclusion Bowel preparation can be performed with vivonex in place of traditional methods due t o its protecting gut barrier functio n and reducing postoperative infectious complications rate.[

关 键 词：直肠癌 术前 vivonex 菌群分析 并发症 肠道准各 结肠癌 

分 类 号：R735.3[医药卫生—肿瘤]