肠道菌群调节联合胃肠神经刺激对腹腔镜结肠癌根治术后POI的影响

Effects of Intestinal Flora Regulation Combined with Gastrointestinal Nerve Stimulation on POI after Laparoscopic Radical Resection of Colon Cancer

目的:观察肠道菌群调节联合胃肠神经刺激防治腹腔镜结肠癌根治术后肠梗阻(POI)的临床效果,探讨其初步可能机制。方法:选取2020年1月-2022年6月宜春市人民医院收治的腹腔镜结肠癌根治术后患者60例作为研究对象,随机分成三组,即对照组、研究A组和研究B组,各20例,对照组采用常规围手术期处理,研究A组围手术期单服双歧杆菌四联活菌片。研究B组在研究A组的治疗基础上联合胃肠神经刺激干预。收集三组的临床POI发生情况(LIFE评分方法),比较三组患者手术前后机体炎症因子,如C反应蛋白(CRP)、白介素-6(IL-6)、5-羟色胺(5-HT)和单核细胞趋化蛋白-1(MCP-1)的变化情况。结果:研究B组POI发生率低于对照组(P<0.05)。研究A组、研究B组CRP、IL-6、5-HT、MCP-1均低于对照组(P<0.05),研究B组CRP、IL-6、5-HT、MCP-1均低于研究A组(P<0.05)。研究B组总有效率均高于研究A组、对照组(P<0.05)。结论:肠道菌群调节联合胃肠神经刺激能够有效减少腹腔镜结肠癌根治术后POI的发生。

Objective:To observe the clinical effect of intestinal flora regulation combined with gastrointestinal nerve stimulation in the prevention and treatment of postoperative ileus(POI)after laparoscopic radical resection of colon cancer,and to explore its preliminary possible mechanism.Method:A total of 60 patients with postoperative laparoscopic colon cancer radical resection who were treated from January 2020 to June 2022 in Yichun People's Hospital were selected as the research objects and randomly divided into the control group,the study group A and the study group B,20 cases in each group,the control group was adopted routine perioperative treatment,study group A was given perioperative oral Bifidobacterium Quadruple Viable Tablet alone,study group B was combined with gastrointestinal nerve stimulation intervention based on the treatment of study group A.The incidence of clinical POI(LIFE scoring method)in the three groups was collected,and then the inflammatory factors such as C reactive protein(CRP),interleukin-6(IL-6),serotonin(5-HT)and monocyte chemoattractant protein-1(MCP-1)changes were compared between the three groups before and after surgery.Result:The incidence of POI in study group B was lower than that in the control group(P<0.05).The CRP,IL-6,5-HT,MCP-1 of study group A and study group B were lower than those in the control group(P<0.05).The CRP,IL-6,5-HT,MCP-1 of study group B were lower than those of study group A(P<0.05).The total effective rate of study group B was higher than those in the study group A,control group(P<0.05).Conclusion:Intestinal flora regulation combined with gastrointestinal nerve stimulation can effectively reduce the occurrence of POI after laparoscopic radical colon cancer resection.