皮下持续负压引流术联合微生态制剂对结直肠癌患者术后切口感染率、菌群变化及免疫功能的影响

Influence of Hypodermic Long-standing Vaccum Drainage Combined with Microecological Preparation on the Incision Infected rate and Enteric Flora Change of Colorectal Cancer Patients Underwent Surgery

目的:探究皮下持续负压引流术联合微生态制剂对结直肠癌患者术后切口感染率、菌群变化及免疫功能的影响。方法:将90例接受外科切除术治疗的结直肠癌患者随机分为对照组和观察组,每组45例。对照组患者进行常规肠道准备和皮下持续负压引流术,观察组患者在对照组基础上联合微生态制剂治疗,观察2组患者手术相关指标、肠道菌群变化情况、免疫指标及术后并发症发生情况。结果:2组患者手术时间、切口长度比较差异无统计学意义(P>0.05),观察组患者术后首次进食时间、住院时间和创口愈合时间均短于对照组(P <0.05);术后7d观察组患者大肠埃希菌、肠球菌明显低于对照组(P <0.05),乳酸杆菌、双歧杆菌明显高于对照组(P <0.05);术后7d观察组患者TNF-α、IL-6明显低于对照组(P <0.05),CD4^(+)和CD8^(+)明显高于对照组(P <0.05)。观察组患者术后出血、切口感染等并发症发生率明显低于对照组(P <0.05)。结论:皮下持续负压引流术联合微生态制剂可减少切口感染、调节肠道菌群、提高免疫力,更有利于患者术后恢复。

Objective To investigate the influence of hypodermic long-standing vaccum drainage(HDLSVD)combined with microecological preparation on the incision infected rate and enteric flora change of colorectal cancer patients underwent surgery. Methods The 90 colorectal cancer patients to be subject to resection were randomly divided into control group(45 cases,routine enteric preparation and HDLSVD)and observation group(45 cases,based on control group,added with microecological preparation);both groups’ operative norms,enteric flora changes,immunological norms,hospitalization time and wound healing time were observed. Results In operating time and incision length there was no statistical difference between the two groups(P >0.05);in the time for postoperative first eating,for hospitalization,and for wound healing;in the amount of E.Coli and enterococcus 7 days after surgery;in the amount of lactobacillus and bifidobacterium 7 days after surgery;in the levels of TNF-αand IL-6 7 days after surgery;in the levels of CD4^(+)and CD8^(+)7 days after surgery;as well as in the incidence of postoperative bleeding and incision infection observation group was respectively and significantly shorter;lower;higher;lower;higher;as well as lower than control group(all,P <0.05). Conclusion HDLSVD combined with microecological preparation can reduce incision infected,regulate enteric flora,enhance immunity,therefore,more beneficial to patients’ postoperative recovered.