中国现代手术学杂志2019，Vol.23Issue(1)：26-29,4.DOI:10.16260/j.cnki.1009-2188.2019.01.006
脾肾分流术对门静脉高压症肠道菌群失调、细菌移位的保护作用
Effects of the Splenorenal Shunt on the Intestinal Flora Imbalance and Intestinal Bacterial Translocation in Patients with Cirrhotic Portal Hypertension
谢小丰 1李介秋 1许玉春 1彭浩 1陈向1
作者信息
- 1. 中国人民解放军联勤保障部队第九二一医院普通外科, 长沙 410003
- 折叠
摘要
Abstract
Objective To investigate the effects of the splenorenal shunt (SRS) on the intestinal flora imbalance and intestinal bacterial translocation in patients with cirrhotic portal hypertension. Methods 75 patients with hemorrhagic esophageal varices secondary to cirrhotic portal hypertension were divided into the SRS group and the esophogeogastric devascularizatiom(EGD) group retrospectively. The 15-day postoperative digestive symptom relief was invested. And bacteria culture and inflammatory mediators such as procalcitonin(PCT), tumor necrosis factor(TNF-α) and interleukin 6(IL-6) level of the abdominal fluid were studied. Results In the SRS group, the digestive symptoms such as abdominal distension, anorexia, constipation and diarrhea were significantly relieved 15 days after operation. The positive rate of bacterial culture in peritoneal exudate (12％, 6 /50) were significantly lower than that of the EGD group (44％, 11 /25) (P＜0.05). And the concentration of inflammatory medium in peritoneal exudate of the SRS was lower than of the EGD group(P＜0.05). There was significant intestinal flora imbalance in the two groups on the first day after operation(P＜0.05). In the SRS group, the dominant intestinal flora (Bifidobacterium and Lactobacillus) proliferated and the pathogenic bacteria (Escherichia coli and Enterococcus) were inhibited on the third day after operation. The EGD group returned to normal level 7 days after operation, and the SRS group was significantly better than the SRS group at the same time (P＜0.05). Conclusion The SRS may improve the intestinal flora imbalance by inhibition of bacterial translocation in patients with cirrhotic portal hypertension.关键词
高血压,门静脉/脾肾分流术,外科/贲门周围血管离断术/菌群移位Key words
hypertension, portal/splenorenal shunt, surgical/pericardiac devascularization/bacterial translocation分类
医药卫生引用本文复制引用
谢小丰,李介秋,许玉春,彭浩,陈向..脾肾分流术对门静脉高压症肠道菌群失调、细菌移位的保护作用[J].中国现代手术学杂志,2019,23(1):26-29,4.
