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目的:对结直肠手术后病人应用肠道微生态制剂治疗的效果进行评价。方法:前瞻性、单盲、随机、对照临床试验。将32例结直肠中等以上手术的病人,随机分为试验组和对照组,每组各16例。试验组病人于术后第3天给予肠内营养+双歧杆菌/嗜酸性乳杆菌/粪链球菌(菌品名:金双歧),每天2次,每次4片,直至出院。对照组只给予肠内营养支持。观察病人术前及术后4～8d的胃肠道症状、生命体征、粪便性状及量和菌群比例等。结果:①胃肠道症状:两组病人术后恶心、呕吐、肠鸣音恢复等差异均无显著性意义(P>0.05),总腹胀天数、总腹痛天数在两组间差异有显著性意义(P<0.05)。②腹泻及腹泻评分:两组病人在术后第6天腹泻例数差异有显著性意义(P<0.05),总腹泻天数、总腹泻人数两组间差异有显著性意义(P<0.05)。两组病人腹泻评分在术后第6天有显著性意义。③菌群比例:试验组病人菌群比例(杆菌/球菌)术后3次均比对照组高,术后第2次监测,两组间差异有显著性意义(P<0.05)。结论:在结直肠术后病人中,应用肠道微生态制剂可改善病人胃肠道症状、减轻腹泻严重程度和纠正肠道菌群失调。
OBJECTIVE: To evaluate the efficacy of gut microecological agents in patients after colorectal surgery. Methods: Prospective, single-blind, randomized, controlled clinical trial. 32 patients with moderate to moderate colorectal surgery were randomly divided into experimental group and control group, with 16 cases in each group. Patients in the experimental group were given enteral nutrition + Bifidobacterium / Lactobacillus acidophilus / Streptococcus faecalis (strain name: Bifidobacterium) on the 3rd day after the operation, twice a day for 4 times each until discharged. Control group only given enteral nutrition support. Observe the gastrointestinal symptoms, vital signs, stool characteristics, quantity and flora proportion of patients before and after 4 ~ 8 days. Results: ① Gastrointestinal symptoms: There was no significant difference in postoperative nausea, vomiting and bowel sounds recovery between the two groups (P> 0.05). The total number of days of abdominal distension and the total number of days of abdominal pain were significantly different between the two groups (P <0.05). ② diarrhea and diarrhea score: two groups of patients on the 6th day after diarrhea cases were significantly different (P <0.05), the total number of diarrhea days, the total number of diarrhea between the two groups was significantly different (P <0.05). The diarrhea score of two groups had significant significance on the 6th day after operation. (3) The proportion of bacteria: the proportion of patients in the experimental group (bacilli / bacteria) was higher than that of the control group three times after operation and the second time after the operation, the difference was significant (P <0.05). Conclusion: The application of intestinal probiotics in patients with colorectal surgery can improve gastrointestinal symptoms, reduce the severity of diarrhea and correct the imbalance of intestinal microflora.