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目的:探讨结直肠手术对结直肠癌患者肠道菌群的影响及微生态制剂治疗肠道菌群失调的效果。方法:选择50例结直肠癌择期手术患者随机分为微生态组和对照组各25例,术后对照组常规处理,微生态组给予三联活菌制剂口服治疗,采用细菌DNA PCR分析定量肠道细菌量,检测血浆D-乳酸和尿L/M水平,对比手术前后肠道菌群变化和肠道屏障功能。结果:术后10天双歧杆菌、乳酸杆菌显著降低,而微生态组显著高于对照组,大肠杆菌、粪肠球菌显著升高,微生态组显著低于对照组,B/E呈显著倒置,对照组倒置更为显著(P值<0.05);术后60天,微生态组双歧杆菌、乳酸杆菌、大肠杆菌、粪肠球菌量及B/E基本恢复术前水平,而对照组仍显著低于术前(P值<0.05)。术后1天血浆D-乳酸和尿L/M水平显著升高(P值<0.05),术后10天两组血浆D-乳酸和尿L/M水平均回落,微生态组回落较对照组显著且显著低于对照组(P值<0.05)。结论:结直肠癌术后患者肠道内双歧杆菌、乳酸杆菌等益生菌显著减少,大肠杆菌和粪肠球菌显著增加,肠道菌群严重失调,肠道屏障功能受损,微生态制剂治疗有助重建肠道菌群平衡,恢复肠道屏障功能。
Objective: To investigate the effect of colorectal surgery on intestinal microflora in patients with colorectal cancer and the effect of microecological preparations on intestinal dysbacteriosis. METHODS: Fifty patients undergoing elective surgery for colorectal cancer were randomly divided into two groups: the microecological group and the control group. Each group was treated in the control group. The microecological group was given orally with the triple viable cell preparation. The bacterial DNA PCR analysis was used to quantify the intestinal tract. The amount of bacteria, plasma D-lactate and urine L/M levels were measured, and changes in intestinal flora and intestinal barrier function before and after surgery were compared. RESULTS: Bifidobacteria and Lactobacillus were significantly decreased in 10 days after operation, while those in the microecological group were significantly higher than those in the control group. E. coli and E. faecalis were significantly increased. The microecological group was significantly lower than the control group. B/E was significantly inverted. The control group was more inversion (P<0.05); 60 days after the operation, the Bifidobacterium, Lactobacillus, Escherichia coli, Enterococcus faecalis, and B/E levels were basically restored before surgery, while the control group remained Significantly lower than preoperative (P value < 0.05). Plasma D-lactate and urinary L/M levels were significantly increased on the 1st postoperative day (P<0.05). D-lactate and urinary L/M levels in the two groups decreased at 10 days postoperatively, and the microecological group returned more than the control group. Significantly and significantly lower than the control group (P value < 0.05). Conclusion: Postoperative colorectal cancer patients with Bifidobacterium, Lactobacillus and other probiotics were significantly reduced, E. coli and E.faecalis were significantly increased, intestinal flora was severely degraded, intestinal barrier function was impaired, and probiotics were treated. Helps to reconstruct intestinal flora balance and restore intestinal barrier function.