术中结肠灌洗对肠道细菌的影响及临床应用价值

Effect of Intraoperative Irrigation of Colon on Intestinal Bacteria and Its Clinical Application

目的:探讨术中结肠灌洗在左半结肠癌并急性肠梗阻中对肠道细菌的影响及在临床上的应用价值。方法:60例左半结肠癌并急性肠梗阻(治疗组)患者行术中结肠灌洗、肿瘤Ⅰ期切除吻合,对其中18例进行结肠灌洗前、后,肿瘤近端肠内容物及肠黏膜作细菌计数及培养,12例左半结肠癌为对照组。结果:治疗组患者近端肠内容物和肠黏膜的细菌数明显高于对照组(P=0.021,P=0.014);经术中结肠灌洗后,近端肠内容物细菌数和近端肠黏膜细菌数治疗组比对照组明显减少(P=0.004,P=0.013)。结论:术中结肠灌洗和肿瘤Ⅰ期切除吻合在治疗左半结肠癌并急性肠梗阻是安全的、可行的。

Objective： To study the effect of intraoperative irrigation of colon on intestinal bacteria in the acute obstruction of the left colorectal carcinoma and its clinical application. Methods. Sixty patients were performed intraoperative irrigation of colon, with one-stage resection and anastomosis. Eighteen in 60 cases were collected before and after intraoperative irrigation of colon to be bacteria count and culture. Twelve cases with left colonic cancer were included as control group. Results： The bacteria of the colonic contents and mucosa proximal to the tumor in the treatment group before irrigation were significantly higher than those of the control group（ P=0.021, P =0.014）. After intraoperative irrigation of colon, the bacteria of the colonic contents and mucosa proximal to the tumor in the treatment group were significantly lower than those of the control group（ P =0.004, P =0.013）. Conclusion： Intraoperative irrigation of colon with one-stage resection and anastomosis for acute obstruction of the left colorectal carcinoma are safe and feasibility.