围手术期口服益生菌在直肠癌根治术后的效果观察

Effect of Oral Probiotics During Perioperative Period on Rectal Cancer after Radical Resection

目的:探讨围手术期口服益生菌在直肠癌根治术后的效果。方法:选取我院2022年1月至2023年12月行直肠癌根治术患者64例,将其分为观察组33例和对照组31例。观察组患者在术前11 d和术后第3天口服复合益生菌,对照组患者口服安慰剂(麦芽糊精和淀粉),剂量与服用时间与观察组一致;比较2组患者手术相关指标、炎症水平、肠屏障功能和腹腔感染率及术后梗阻发生率。结果:观察组患者术中出血量、首次排气时间以及住院时间均少于或短于对照组(P<0.05)。术前11 d 2组患者炎症水平和肠屏障功能比较差异无统计学意义(P>0.05);术前1 d、术后3 d和7 d,观察组患者血清肿瘤坏死因子-α(TNF-α)和C-反应蛋白(CRP)水平均明显低于对照组(P<0.05)。术前1 d、术后3 d和7 d,观察组患者血清二胺氧化酶(DAO)和内毒素均明显低于对照组(P<0.05)。术后1个月内,观察组患者腹腔感染率和术后梗阻发生率均低于对照组,但无统计学差异(P>0.05)。结论:在围手术期口服益生菌有利于维持直肠癌根治术患者机体稳态,减少炎症反应和肠屏障功能受损,促进术后恢复,但对腹腔感染率及术后梗阻发生率的影响,仍需进一步研究。

Objective To investigate the effect of oral probiotics during perioperative period on rectal cancer after radical resection.Methods Total 64 patients who underwent radical resection for rectal cancer in our hospital from January 2022 to December 2023 were selected and divided into observation group(33 cases)and control group(31 cases).Patients in the observation group were given oral adminis-tration of complex probiotics 11 days before operation and 3 days after operation.Patients in the control group were given oral administration of placebo(maltodextrin and starch),and the dose and time of admin-istration were consistent with those in the observation group.The operative indicators,inflammation level,intestinal barrier function,abdominal infection rate and postoperative obstruction rate were compared be-tween the two groups.Results The operative blood loss,first exhaust time and hospital stay in the ob-servation group were less than or shorter than those in the control group(P<0.05).There was no sig-nificant difference in inflammation level and intestinal barrier function between the two groups 11 days be-fore operation(P>0.05).Serum levels of tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)in the observation group were significantly lower than those in the control group one day before op-eration,3 days and 7 days after operation(P<0.05).Serum diamine oxidase(DAO)and endotoxin in the observation group were significantly lower than those in the control group one day before operation,3 days and 7 days after operation(P<0.05).Within 1 month after operation,the incidence of abdominal infection and postoperative obstruction in the observation group was lower than that in the control group,but there was no statistical difference(P>0.05).Conclusion Oral administration of probiotics during perioperative period is beneficial to maintaining body homeostasis in patients undergoing radical resection of rectal cancer,reducing inflammatory response and intestinal barrier dysfunction,and promoting postop-erative recovery.However,the effect on abdominal infection rate and incidence of postoperative obstruction still need to be further studied.