摘要
目的探讨益生菌联合乳果糖对体外循环心内直视术后胃肠功能及感染发生的影响。方法回顾性分析2013年8月至2014年6月在我院行体外循环辅助的心脏病患者264例的临床资料,男129例、女135例,年龄(53.06±10.97)岁。将264例患者分为两组,其中治疗组121例,男58例、女63例,年龄(53.25±9.27)岁,术后第1天开始使用益生菌联合乳果糖,用至术后第7天;对照组143例,男71例、女72例,年龄(52.29±14.31)岁,未使用益生菌及乳果糖。两组均在术前、术后24 h、72 h及7 d抽血测定降钙素原(PCT)及内毒素(LPS)浓度,记录术后感染、胃肠功能障碍等相关情况。结果治疗组术后72 h的PCT[(1.04±5.39)ng/ml vs.(3.51±4.28)ng/ml,P=0.04)]及LPS[(11.28±4.34)EU/ml vs.(21.59±7.34)EU/ml,P=0.03)]均明显低于对照组,治疗组术后7天的PCT[(0.17±2.79)ng/ml vs.(1.98±4.62)ng/ml,P=0.04]及LPS[(6.74±6.38)EU/ml vs.(15.96±4.61)EU/ml,P=0.01)]均明显低于对照组;治疗组术后ICU停留时间[(43.25±14.36)h vs.(63.47±24.46)h,P=0.01]及术后住院时间[(15.07±4.52)d vs.(21.08±6.49)d,P=0.02]明显短于对照组;治疗组术后感染率为1.65%,胃肠功能障碍为2.48%,死亡率1.65%,对照组分别为5.59%,6.99%和2.10%(P=0.00,P=0.12)。结论体外循环心内直视术后早期使用益生菌联合乳果糖可能降低机体炎症反应,改善胃肠功能,降低感染发生率。
Objectives To investigate the effect of the combined treatment with probiotics and lactulose of gastrointestinal function and postoperative infection after open cardiac surgery. Methods We retrospectively analyzed the clinical data of 264 patients underwent cardiopulmonary bypass in our hospital between August 2013 and June 2014. There were 129 males and 135 females at the mean age of 53.06±10.97 years. We divided those patients into a treatment group and a control group. In the treatment group,there were 58 males and 63 females at the mean age of 52.29±14.31 years. They took probiotics and lactulose from the first day to the seventh day after operation. In the control group,there were 71 males and 72 females at the mean age of 52.29±14.31 years. They didn＇t take probiotics or lactulose after the surgery. Procalcitonin（PCT） and lipopolysaccharides（LPS） concentrations were measured before operation,at 24 hours postoperatively,at 72 hours and on the seventh day. We recorded the condition of postoperative infection,gastrointestinal disorders and relative informations. Results The PCT and LPS concentrations in the treatment group after 72 hours postoperatively were statistically lower than those of the control group（1.04±5.39 ng/ml vs. 3.51±4.28 ng/ml,P=0.04; 11.28±4.34 EU/ml vs. 21.59±7.34 EU/ml,P=0.03）. The PCT and LPS concentrations in the treatment group were also statistically lower than those of the control group on the 7th day postoperatively（0.17±2.79 ng/ml vs. 1.98±4.62 ng/ml,P=0.04; 6.74±6.38 EU/ml vs. 15.96±4.61 EU/ml,P=0.01）. The ICU stay time（43.25±14.36 h vs. 63.47±24.46 h,P=0.01） and postoperative hospital stay time（15.07±4.52 d vs. 21.08±6.49 d,P=0.02） were significantly less in the treatment group than those in the control group. The morbidity of infection and the morbidity of gastrointestinal disorders of the treatment group were statistically less than those of the control group（1.65% vs. 5.59%,P=0.00; 2.48% vs. 6.99%,P0.001）,and there was no statistical difference in mortality between the two groups（1.65% vs. 2.10%,P=0.12）. Conclusions The combined treatment with probiotics and lactulose can improve the postoperative inflammatory reaction,gastrointestinal function,and reduce the morbidity of infection.
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2016年第6期569-572,共4页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
广东省科技计划(2008B060600064)~~
关键词
益生菌
乳果糖
体外循环
心内直视术
Probiotics
Lactulose
Cardiopulmonary bypass
Open cardiac surgery
