烧伤早期大面积切痂术后肠道菌群变化的初步临床研究

Clinical study on changes in intestinal flora in burn patients after early extensive escharectomy

目的 :探讨烧伤早期大面积切痂术后肠道菌群变化规律及其意义。方法 :采用定量和微生物分析法对大面积切痂术后 2 9例患者 (手术组 )的血浆内毒素和肠道 6种常见菌群 (肠杆菌、葡萄球菌、双歧杆菌、类杆菌、梭杆菌和酵母菌 )进行检测 ,并与 2 0名正常人进行对照分析。结果 :手术组的肠杆菌、酵母菌数量明显高于正常对照组 ,厌氧菌中类杆菌、梭杆菌、双歧杆菌数量及双歧杆菌 /肠杆菌明显低于正常对照组 (P均 <0 .0 5或 P<0 .0 1) ,血浆内毒素水平显著高于正常对照组 (P均 <0 .0 1)。 2 9例患者中 2 4例出现不成形软便或稀便等肠道菌群失调症状。结论 :肠道菌群失调存在于大面积切痂术后早期 ,主要是以双歧杆菌为代表的厌氧菌群失调 。

Objective:To explore the change in intestinal flora and its significance in burn patients undergoing early escharectomy en masse (EEEM).Methods:Contents of plasma endotoxin and six kinds of intestinal flora in faeces were assayed in 29 EEEM patients by microbiologic methods,and were compared with 20 healthy controls.Results:The results showed that the counts of enteric bacilli and candida in EEEM patients were markedly higher than those in the controls,while the counts of bacteroid and bifidobateria in EEEM patients were lower than normal controls.Plasma endotoxin contents significantly increased in EEEM patients compared to normal controls.Among 29 EEEM patients 24 had diarrhea.Conclusions:These data indicate that the imbalance of intestinal flora could exist during the early stage after EEEM.It is characterized by the disorder of anaerobic bacilli such as bifidobacteria,which might be an important cause associated with intestinal infection.