腹腔镜结肠癌根治术对老年结肠癌合并低蛋白血症患者肠道菌群失调的影响及三联活菌制剂的干预效果

EFFECT OF ALZHEIMER'S DISEASE WITH PROTEIN PEARL TINNITUS AND TINNITUS,EFFECT ON REACTION OF LOW-YOUNG GROUP,EFFECT AND EFFECT OF TRIPLE LIVING INFANTS

目的 探讨老年结肠癌合并低蛋白血症患者采用腹腔镜结肠癌根治术治疗对肠道菌群失调的影响及采用三联活菌制剂的干预的效果。方法 选取成都市第二人民医院2018年10月—2020年10月接受腹腔镜结肠癌根治术治疗的结肠癌患者165例进行临床研究,对比患者手术前、手术后的肠道菌群计数、肠道菌群失调分级的差异,并将165例肠道菌群失调的患者分为观察组83例和对照组82例,观察组给予三联活菌制剂+柳氮磺吡啶肠溶片治疗、对照组给予柳氮磺吡啶肠溶片治疗;对比二组治疗前后的肠道菌群数量、肠道屏障功能指标、免疫功能、血清炎症因子水平及临床疗效的差异。结果 术后,患者的平均大肠杆菌、场球菌、葡萄球菌数量较术前均显著升高(P<0.05);患者的肠道酵母菌、双歧杆菌、乳酸杆菌数量较术前显著降低(P<0.05);术后,患者达到肠道均失调Ⅲ度患者的占比为20.61%、Ⅱ度患者占比59.39%、Ⅰ度患者占比20.00%,较术前显著升高(P<0.05);干预前,二组患者的大肠杆菌、场球菌、葡萄球菌、酵母菌、双歧杆菌、乳酸杆菌数量差异无统计学意义(P>0.05);干预后,观察组的场球菌、葡萄球菌数量低于对照组,观察组的酵母菌、双歧杆菌、乳酸杆菌数量均高于对照组,差异有统计学意义(P<0.05);干预前,二组患者的血清D-乳酸、L/M值比较,差异无统计学意义(P>0.05);干预后,观察组的血清D-乳酸、L/M值低于对照组,差异有统计学意义(P<0.05);干预前,二组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)比较,差异无统计学意义(P>0.05);干预后,观察组的CD4^(+)/CD8^(+)高于对照组,差异有统计学意义(P<0.05);干预前,二组患者的血清TNF-α、IL-6、IL-8水平比较,差异无统计学意义(P>0.05);干预后,观察组的血清TNF-α、IL-6低于对照组,差异具有统计学意义(P<0.05);干预后,观察组的干预效果优于对照组,差异有统计学意义(P<0.05)。结论老年结肠癌合并低蛋白血症患者采用腹腔镜结肠癌根治术治疗会加重肠道菌群失调的情况,采用三联活菌制剂+柳氮磺吡啶肠溶片治疗对于纠正肠道菌群失调、减轻炎症反应及手术对免疫功能的影响,促进肠道屏障功能恢复方面效果显著。

Objective To explore the effect of laparoscopic radical resection of colon cancer in elderly patients with colon cancer with hypoproteinemia on the imbalance of intestinal flora and the effect of intervention with triple live bacteria preparations.Methods One hundred and sixty-five colon cancer patients who underwent laparoscopic radical resection of colon cancer from Chengdu Second People's Hospital from October 2018 to October 2020 were selected for clinical research to compare the intestinal flora counts and the classification of intestinal flora imbalances of patients before and after surgery Divided 165 patients with intestinal flora imbalance into a treatment group of 83 cases and a control group of 82 cases.The treatment group was treated with triple viable bacteria preparation + sulfasalazine enteric-coated tablets,and the control group was treated with sulfasalazine intestine.Dissolving tablets treatment;compare the differences in the number of intestinal flora,intestinal barrier function indexes,immune function,serum inflammatory factor levels and clinical efficacy between the two groups before and after treatment.Results After the operation,the patients' average number ofE.coli,coccus and staphylococci were significantly higher than those before the operation(P<0.05);the patient's intestinal yeast,bifidobacteria,and lactobacillus numbers were significantly lower than that before the operation( P<0.05);after the operation,the proportion of patients with intestinal disorders Ⅲ degree was 20.61%,the proportion of Ⅱ degree patients was 59.39%,and the proportion of Ⅰ degree patients was 20.00%,which was significantly higher than that before operation(P<0.05);before the intervention,there was no significant difference in the numbers of Escherichia coli,Staphylococcus,Staphylococcus,yeast,Bifidobacterium,and Lactobacillus between the two groups of patients(P>0.05);After the intervention,the number of Staphylococcus and Staphylococcus in the treatment group was not statistically significant.The number of cocci was lower than that of the control group,and the numbers of yeast,bifidobacteria,and lactobacilli in the treatment group were higher than those in the control group.The difference was statistically significant(P<0.05);before the intervention,the serum D-lactic acid and L levels of the two groups of patients/M value comparison,the difference was not statistically significant(P>0.05);after the intervention,the serum D-lactic acid and L/M values of the treatment group were lower than those of the control group,and the difference was statistically significant(P<0.05);before the intervention,There was no significant difference in CD3^(+),CD4^(+),CD4^(+)/CD8^(+) between the two groups of patients(P>0.05);after intervention,the CD4^(+)/CD8^(+) of the treatment group was higher than that of the control group,and the difference was statistically significant(P<0.05);Before,the serum TNF-α,IL-6,and IL-8 levels of the two groups were not statistically different(P>0.05);after the intervention,the serum TNF-α and IL-6 levels of the treatment group were lower than those of the control group,The difference was statistically significant(P<0.05);after the intervention,the intervention effect of the treatment group was better than that of the control group,and the difference was significant(P<0.05).Conclusion Elderly patients with colon cancer combined with hypoproteinemia can aggravate the intestinal flora imbalance by laparoscopic radical resection of colon cancer.The use of triple live bacteria preparation + sulfasalazine enteric-coated tablets can correct the intestinal flora imbalance and reduce The effect of inflammation and surgery on immune function is significant in promoting the recovery of intestinal barrier function.