选择性消化道去污染预防肠源性感染的研究

A study on selected decontamination of the digestive tract to prevent bowel-originated infection

[目的 ]探讨选择性消化道去污染 (SDD)对体外循环风湿性心脏病瓣膜置换术病人肠源性感染的影响。 [方法 ]选择风湿性心脏病瓣膜置换术体外循环病人 2 8例 ,随机分为对照组和SDD组 ,对照组行常规术前肠道准备 ,即饮食准备和清洁灌肠 ;SDD组在常规准备的基础上进行选择性消化道去污染干预。检测两组病人肠道菌群、内毒素水平的变化。 [结果 ]体外循环后病人体内内毒素水平显著增高 (P <0 .0 1) ;选择性消化道去污染能减少肠道革兰氏阴性菌群数量和降低体内内毒素水平 (P <0 .0 5 )。 [结论 ]选择性消化道去污染是去除肠道潜在致病菌、预防肠源性内毒素血症的有效肠道准备方法。

Objective: to probe into the influence of selected decontamination of the digestive tract(SDD) on bowel-originated infection in patients with rheumatic heart disease underwent valve replacement under extracorporeal circulation. Method: a total of 28 patients were selected and divided into control group and SDD group. Patients in control group were given bowel preparation as routine before operation including diet preparation and cleaning enema. While patients in SDD group were given selected digestive tract depollution as intervention besides routine preparation. Then the changes of intestinal bacterial flora and endotoxin levels of patients in the two groups were detected.Result: endotoxin levels of patients after extracorporeal circulation were increased obviously (P<0.05).Selected decontamination of the digestive tract can both reduce the quantity of Gram-negative bacteria flora of intestinal tract and the endotoxin level of patients(P<0.05).Conclusion: it showed that selected decontamination of the digestive tract is an effective way of bowel preparation both to eliminate bowel potential pathogenic bacterium and to prevent bowel-originated endotoxemia for patients with rheumatic heart disease underwent valve replacement under extracorporeal circulation.