早期调节肠道菌群对结肠癌根治术患者的临床意义

Clinical significance of early regulation of intestinal flora in patients undergoing radical resection of colon cancer

目的探讨早期调节肠道菌群对结肠癌根治术患者早期恢复及应激、免疫功能的影响。方法回顾性分析2017年1月至2018年12月于我院胃肠外科行择期结肠癌根治术的85例患者临床资料,将术前2周行肠道菌群调节的患者为干预组(40例),无肠道菌群调节患者为对照组(45例)。采用SPSS24.0进行数据分析及处理。临床指标、肠道菌群数、免疫功能及炎症反应指标等以(x±s)描述,组间比较采用独立样本t检验,组内比较采用配对样本t检验,P<0.05表示差异有统计学意义。结果干预组术后发热时间短于对照组(P<0.05);干预组患者干预前4种肠道菌群数目与对照组术前1 d相比,差异无统计学意义(P>0.05);干预组患者术前1 d较干预前粪便中双歧杆菌属、乳酸杆菌属数目明显增多(P<0.05),大肠杆菌属及肠球菌属数目明显减少(P<0.05);术后3 d干预组患者双歧杆菌、乳酸杆菌数目明显多于对照组,而大肠杆菌、肠球菌数目明显少于对照组,差异均有统计学意义(P<0.05);术后3 d,干预组患者IL-6及CRP水平均显著优于对照组(P<0.05)。结论早期调节肠道菌群能有效改善结肠癌患者术后肠道菌群的紊乱,减轻患者术后机体应激。

Objective To investigate the effect of early regulation of intestinal flora on early recovery, stress and immune function in patients undergoing radical resection of colon cancer.Methods The clinical data of 85 patients underwent elective radical resection of colon cancer in our hospital from January 2017 to December 2018 were retrospectively analyzed. The patients who were given intestinal flora regulation 2 weeks before operation were divided into intervention group(40 cases) and those without intestinal flora regulation were divide into control group(45 cases). SPSS24.0 was used for data analysis. Clinical indicators, number of intestinal flora, immune function and inflammatory response indicators were described by (x±s). Independent sample t test was used for inter-group comparison, paired sample t test was used for intra-group comparison, P<0.05 indicated statistically significant difference.Results The fever time of intervention group was shorter than that of control group(P<0.05).There was no significant difference in the number of four kinds of intestinal flora in the intervention group compared with that in the control group 1 d before the operation(P>0.05);The number of bifidobacteria and lactobacillus in feces in the intervention group was significantly increased(P<0.05), and the number of escherichia coli and enterococci was significantly decreased(P<0.05);The number of bifidobacteria and Lactobacillus in the intervention group was significantly more than that in the control group on the 3 rd day after operation, while the number of Escherichia coli and Enterococcus was significantly less than that in the control group( P < 0. 05). The levels of IL-6 and CRP in the intervention group were significantly lower than those in the control group on the 3 rd day after operation( P < 0. 05). Conclusion Early regulation of intestinal flora can effectively improve the intestinal flora disorder after colon cancer surgery and reduce postoperative stress.