摘要
目的探究本院胃肠道肿瘤术后患者菌群失调的易感因素,发现高危人群,以期降低其发病率并提高治疗效果。方法收集2012年6月至2013年12月在中山大学附属第一医院胃肠外科中心诊断胃癌或结直肠癌并接受手术治疗的患者1 302例。回顾性分析患者的临床病理资料,分析患者术后肠道菌群失调的易感因素。结果本组有症状肠道菌群失调发生189例（14.5%）。肠道菌群易感因素包括：1性别（OR=0.571,95%CI：0.381~0.855,P=0.007）;2抗生素使用超过10天（OR=38.542,95%CI：23.139~64.198,P〈0.001）;3术前肠梗阻（OR=1.897,95%CI：1.017~3.539,P=0.044）;4使用3~4代头孢菌素（OR=1.689,95%CI：1.125~2.537,P=0.011）、碳青霉烯类（OR=24.070,95%CI：7.080~81.891,P〈0.001）、喹诺酮类抗生素（OR=38.512,95%CI：7.457~198.898,P〈0.001）。结论术后长期广谱抗生素应用是术后肠道菌群失调的主要原因。对有高危因素的患者,应早期监测,早期诊断,并根据药敏试验选择窄谱抗生素。
Objective To investigate the predisposing factors for postoperative dysbacteriosis in the patients with gastrointestinal（GI） tumors. Methods From June 2012 to Dec 2013, clinicopathological data of 1302 cases with GI tumors undergoingsurgical treatment were retrospectively analyzed. Binary logistic regression method was used to analyze predisposing factors for postoperative dysbacteriosis. Results A total of 189 patients（14.5%） had symptomatic dysbacteriosis. Binary logistic regression revealed that the predisposing factors for postoperative dysbacteriosis included gender（OR =0.571, 95% CI ： 0.381-0.855,P =0.007）, treatment with antibiotic more than 10 days（OR =38.542, 95% CI ： 23.139-64.198, P〈 0.001）, preoperative ileus（OR =1.897, 95% CI ： 1.017-3.539, P =0.044）, III ~IV cephalosporin（OR =1.689, 95% CI ： 1.125-2.537, P=0.011）, carbapenems（OR=24.070, 95% CI ： 7.080-81.891, P〈0.001）and quinolone（OR =38.512, 95% CI ： 7.457-198.898, P〈 0.001）. Conclusions Long-term use of wide spectrum antibiotics were the major reason for postoperative dysbacteriosis in the patients with gastrointestinal tumors. Narrow spectrum antibiotics according to drug sensitive test should be recommended.
出处
《消化肿瘤杂志（电子版）》
2015年第2期73-76,共4页
Journal of Digestive Oncology(Electronic Version)
基金
广东省自然科学基金重点项目(S2013020012724)
关键词
菌群失调
胃肠道肿瘤
术后
Dysbacteriosis
Gastrointestinal neoplasms
Postoperative
