双歧杆菌三联活菌制剂对上消化道穿孔病人术后恢复的影响

余招祥; 昝建宝; 苗祥; 何承龙

doi:10.13898/j.cnki.issn.1000-2200.2020.10.019

双歧杆菌三联活菌制剂对上消化道穿孔病人术后恢复的影响

Effect of bifidobacterium triple viable preparation on the postoperative recovery of patients with upper gastrointestinal perforation

摘要

摘要:
目的探讨双歧杆菌三联活菌制剂对上消化道穿孔病人术后恢复的安全性及有效性。
方法选择60例上消化道穿孔病人作为研究对象，按照随机数字表法分成观察组和对照组，各30例，对照组病人在基础治疗方案之上加入术后早期肠内营养，观察组在对照组基础上加入双歧杆菌三联活菌制剂的治疗。检测白细胞总数（WBC）、中性粒细胞比例、C反应蛋白（CRP）、降钙素原（PCT）、白细胞介素6（IL-6）、CD3⁺T细胞、CD4⁺ T细胞、CD8⁺T细胞、CD4⁺/CD8⁺等指标，并记录住院时间及术后并发症发生率。
结果术前及术后第1、4天，2组病人WBC、中性粒细胞比例、CRP、PCT、IL-6水平及外周血T淋巴细胞亚群水平差异均无统计学意义（P>0.05）。术后第4天，观察组病人的中性粒细胞比例和IL-6水平低于对照组（P < 0.05）。术后第7天，2组病人的WBC及中性粒细胞比例均基本恢复正常，差异无统计学意义（P>0.05），观察组病人的CRP、PCT及IL-6水平低于对照组（P < 0.05~P < 0.01）。术后第4、7天，观察组CD3⁺、CD4⁺ T淋巴细胞比例、CD4⁺/CD8⁺较对照组高（P < 0.05~P < 0.01），CD8⁺T淋巴细胞比例明显低于对照组（P < 0.01）。观察组病人的住院时间和术后并发症发生率低于对照组（P < 0.01和P < 0.05）。
结论双歧杆菌三联活菌制剂用于上消化道穿孔病人术后的治疗，能增强病人的免疫力，减少全身炎症反应，增强肠道屏障，促进肠道功能快速恢复，降低术后并发症发生率，值得临床应用。

Abstract:
ObjectiveTo investigate the safety and effectiveness of bifidobacterium triple viable preparation in the postoperative recovery of patients with upper gastrointestinal perforation.
MethodsSixty patients with upper gastrointestinal perforation were divided into the observation group and control group by random number table method(30 cases in each group).The control group was treated with early enteral nutrition based on the basic treatment regimen, and the observation group was treated with bifidobacterium triple viable preparation preparation based on the control group.The total white blood cell count(WBC), neutrophil ratio, C-reactive protein(CRP), procalcitonin(PCT), interleukin-6(IL-6), CD3⁺T cells, CD4⁺ T cells, CD8⁺T cells, CD4⁺/CD8⁺ and other indicators were detected in two groups, and the hospital stay and incidence rate of complications were recorded.
ResultsThe differences of the levels of WBC, neutrophil ratio, CRP, PCT, IL-6 and T lymphocyte subsets between two groups before and after 1 and 4 days of surgery were not statistically significant(P>0.05).After 4 days of surgery, the neutrophil ratio and IL-6 level in observation group were lower than those in control group(P < 0.05).After 7 days of surgery, the WBC and neutrophil ratio in two groups basically returned to normal, and the difference of which was not statistically significant(P>0.05), and the levels of CRP, PCT and IL-6 in observation group were lower than those in control group(P < 0.05 to P < 0.01).After 4 and 7 days of operation, the proportions of CD3⁺ T cells and CD4⁺ T cells, and CD4⁺/CD8⁺ in observation group were higher than those in control group(P < 0.05 to P < 0.01), the proportion of CD8⁺ T cells in observation group was significantly lower than that in control group(P < 0.01).The length of hospital stay and incidence rate of complications in observation group were lower than those in control group(P < 0.01 and P < 0.05).
ConclusionsThe bifidobacterium triple viable preparation in the treatment of upper gastrointestinal perforation can strengthen the immunity of patients, reduce systemic inflammatory reaction, enhance intestinal barrier, promote rapid recovery of intestinal function and reduce the incidence of postoperative complications, which is worthy of promotion in clinic.

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