胆道梗阻患者肠道细菌易位的临床观察

Intestinal bacterial translocation in patients with biliary tract diseases

对３５例胆道疾病患者的肠系膜淋巴结、外周静脉血、门静脉血及胆汁进行细菌学研究。３５例中胆道梗阻２３例，胆道未梗阻１２例。结果显示：６５％的胆道梗阻患者出现细菌易位，而非胆道梗阻患者未见细菌易位发生；易位至肠系膜淋巴结者多为Ｇ－肠杆菌。提示肝外胆道梗阻可导致人体肠道细菌易位。

To determine whether intestinal bacterial translocation occurs in man, the authors cultured the tissues of mesenteric lymph nodes(MLNs), bile, portal and peripheral venous blood obtained prior to and during operation in 35 patients with biliary diseases. No positive peritoneal swab, portal blood and peripheral blood culture were shown. Thirteen of 20 patients with biliary obstruction (65%) had bacteria in their MLNs, while no positive MLN culture was found in 12 patients without biliary obstruction. The most common bacteria recovered from the MLNs were Gram negative enteric bacilli. Thus, it is considered that extrahepatic biliary obstruction may induce intestinal bacterial translocation in man.