临床小儿外科杂志2025，Vol.24Issue(3)：215-219,5.DOI:10.3760/cma.j.cn101785-202412011-003
儿童肝移植围手术期肠黏膜屏障功能改变与耐碳青霉烯类肠杆菌定植的相关性研究
Correlation between changes of intestinal mucosal barrier function and carbapenem-resistant enter-obacter colonization during perioperative period of pediatric liver transplantation
摘要
Abstract
Objective To explore the correlation between intestinal mucosal barrier function impairment and rectal colonization of carbapenem-resistant enterobacteria(CRE)during pediatric liver transplantation(LT)and summarize the general rules of postoperative intestinal mucosal impairment and repairing.Methods From November 1st,2022 to December 31 st,2022,40 children with biliary atresia(BA)undergoing LT were assigned into two groups of CRE colonization and non-CRE colonization according to the results of anal swabs.At 24 h pre-operation,24 h post-operation and Day 7 post-operation,vehous blood samples were collected for detecting the levels of D-lactic acid and diamine oxidase(DAO).The inter-group differences and changes of D-lactic acid and DAO were compared.And general rules of intestinal mucosal impairment and repairing post-LT was preliminarily examined.Results The levels of D-lactic acid and DAO peaked at 24 h post-operation in both groups.In CRE colonization group,D-lactic acid of 24 h post-operation and 24 h pre-operation[(0.43±0.09)vs.(0.32±0.12)mg/mL],24 h post-operation and Day 7 post-operation[(0.43±0.09)vs.(0.22±0.07)mg/mL].In non-CRE colonization group,D-lactic acid of 24 h post-operation and 24 h pre-operation[(0.32±0.09)vs.(0.23±0.11)mg/mL],24 h post-operation and Day 7 post-operation[(0.32±0.09)vs.(0.22±0.11)mg/mL];D-lactic acid of 24 h post-operation in CRE colonization and non-CRE coloniza-tion groups[(0.43±0.09)vs.(0.32±0.09)mg/mL].The differences were statistically significant(P＜0.05);In CRE colonization group,DAO of 24 h post-operation and 24 h pre-operation[(0.22±0.04)vs.(0.16±0.05)U/L],24 h post-operation and Day 7 post-operation[(0.22±0.04)vs.(0.18±0.06)U/L].In non-CRE colonization group,DAO of 24 h post-operation and 24 h pre-operation[(0.17±0.01)vs.(0.13±0.02)U/L],24 h post-operation and Day 7 post-operation[(0.17±0.01)vs.(0.15±0.05)U/L],DAO of 24 h post-operation in CRE colonization and non-CRE colonization groups[(0.22±0.04)vs.(0.17±0.01)U/L].The differences were statistically significant(P＜0.05).However,the levels of D-lactic acid and DAO at 24 h pre-operation and Day 7 post-operation had no significant differences in neither groups.The levels of D-lactic acid and DAO at 24 h pre-operation and Day 7 post-operation had no significant inter-group differences.Con-clusions Intestinal mucosal injury peaked within 24 h post-LT and returned to the preoperative level within 1 week.In CRE colonization group,intestinal mucosal barrier injury was more severe than that in non-CRE coloni-zation group.关键词
肝移植/耐碳青霉烯类肠杆菌/D-乳酸/二胺氧化酶/外科手术/儿童Key words
Liver Transplantation/Carbapenem-resistant Enterobacteria/D-lactic Acid/Diamine Oxi-dase/Surgical Procedures,Operative/Child引用本文复制引用
孙雁,王兵,高思楠,窦晓婧,孙超,程悦..儿童肝移植围手术期肠黏膜屏障功能改变与耐碳青霉烯类肠杆菌定植的相关性研究[J].临床小儿外科杂志,2025,24(3):215-219,5.基金项目
国家自然基金项目(32371426) （32371426）
天津市自然科学基金(21JCYBJC01290) （21JCYBJC01290）
天津市卫生健康科技重点学科专项(TJWJ2023XK012) （TJWJ2023XK012）
感染性疾病国家临床重点专科建设项目(8235) National Natural Science Foundation of China(32371426) （8235）
Tianjin Natural Science Foundation(21JCYBJC01290) （21JCYBJC01290）
Tianjin Health Science and Technology Key Discipline Project(TJWJ2023XK012) （TJWJ2023XK012）
National Clinical Key Specialty Project of Infectious Diseases(8235) （8235）
