摘要
目的探讨大肠癌右半结肠切除患者肠道菌群变化及临床意义。方法选取接受右半结肠切除治疗的大肠癌患者43例(观察组),体检健康者43例(对照组)。对照组体检时、观察组手术前后分别留取清晨第一次排便尾便标本,进行细菌培养及菌株计数;观察组分别于术前、术后24 h取空腹肘静脉血进行细菌培养,统计细菌阳性率及DNA检出率。结果对照组、观察组均检出双歧杆菌、乳酸杆菌、大肠杆菌、酵母菌、类杆菌、粪肠球菌和屎肠球菌。观察组手术前后双歧杆菌、乳酸杆菌数量均低于对照组(P均<0.05),大肠杆菌、酵母菌、粪肠球菌和屎肠球菌数量均高于对照组(P均<0.05),术后较术前上述菌株数量变化更显著(P均<0.05)。观察组术前、术后双歧杆菌/大肠杆菌分别为1.04±0.17、0.76±0.09,均低于对照组的1.64±0.23,且术后低于术前,组间及组内比较P均<0.05。观察组术前血细菌培养阳性率和DNA检出率均为0,术后24 h分别为6.98%(3/43)、41.86%(18/43),术前与术后24 h比较P均<0.01。结论右半结肠切除大肠癌患者肠道菌群明显失衡,双歧杆菌与大肠杆菌比值倒置,患者肠道功能减退,易诱发细菌移位,造成围手术期感染。
Objective To investigate the effect and significance of right colon resection on intestinal flora in patients with eolorectal cancer. Methods We selected 43 patients with coloreetal cancer for right hemicoleetomy treatment （ observation group） and 43 healthy subjects （ control group）. The stool samples were obtained in the morning from the first defecation tail in patients of the observation group before and after surgery, while in the control group, the sample were obtained at physical examination in the morning, and then both the stool samples were cultured and underwent bacteria count. The preoperative and postoperative 24 h fasting venous blood was collected for the bacterial culture bacteriain the observation group, and the positive rate of bacteriabacteriadetection rate of DNA was statistically analyzed. Results Bifidobacterium, Lactobacillus, Escherichia eoli （E. coli）, yeast, Bacteroides, Enterococcus faecalis and Enterococcus faecium were detected in two groups. The number of Bifidobaeterium and Lactobacillus was lower in the observation group than that of the control group （ P 〈 0.05 ） , while the number of E. coli, yeast, Enterocoecus faecalis and Enterocoecus faecium was higher than that of the control group （ P 〈0. 05 ）, the postoperative changes in the number of strains were more significant （ P 〈 0. 05 ）. The Bifidobacterium/E. Coli before and after the operation in the observation group were lower than that of the control group （ both P 〈 0.05 ）, and the rate was lower than that after operation in the observation group （ P 〈 0.05 ）. In the observation group, the positive rate of bacterial culture and DNA detection rate before the operation were 0, versus 6.98% （3/43） and 41.86% （ 18/43 ）, respectively, after operation （ all P 〈 0.01 ）. Conclusions Right colon resection for patients with colorectal cancer causes the intestinal flora imbalance accompanied by intestinal dysfunction, Bifidobacterium and E. coli is inverted, and it seems easy to induce bacterial translocation, resulting in perioperative infection.
作者
潘勇
PAN Yong(Sichuan Provincial People＇s Hospital, Chengdu 610041, China)
出处
《山东医药》
CAS
北大核心
2017年第12期48-50,共3页
Shandong Medical Journal
基金
四川省卫生和计划生育委员会科研课题(150217)
关键词
大肠癌
右半结肠切除
肠道菌群
双歧杆菌
大肠杆菌
colorectal carcinoma
right colon resection
intestinal microflora
Bifidobacterium
Eseherichia coli
