术前应用益生菌对胰十二指肠切除术后患者的影响

发布时间：2018-09-13 08:34

【摘要】：目的:目前研究证实,益生菌对人类健康促进发挥着重要的作用,但是对于接受腹部外科手术的患者其临床价值仍不明确,尤其是对胰十二指肠切除患者更是研究甚少,本文主要探究术前口服益生菌对胰十二指肠切除术后患者的影响,从而为围手术期益生菌的应用提供理论依据。方法:(1)选取我院普外科50名行胰十二指肠切除术患者作为研究对象,随机分为口服益生菌组(n=25)及空白对照组(n=25),益生菌组患者术前予以口服益生菌制剂准备,连续规律服用7天,而对照组不予特殊处理。(2)比较两组患者术后感染并发症发生情况,并统计两组患者术后抗生素使用时间。(3)记录两组患者术前及术后血液营养相关指标变化。(4)比较两组患者术后排气排便及进食时间,统计两组患者术后腹泻的发生率。(5)研究两组患者术后住院时间及住院花费等其它指标。结果:(1)益生菌组患者术后感染发生率为16.0%,低于对照组患者44.0%,益生菌组患者术后抗生素使用时间(8.4±3.0)天较对照组(10.8±6.5)天有所缩短,差异有统计学意义(P0.05)。(2)相对于对照组患者,口服益生菌组患者术后12日红细胞计数,血红蛋白、总蛋白及白蛋白水平较高,两者间比较差异有统计学意义(P0.05)。(3)益生菌组患者术后排气排便时间及恢复进食时间均较对照组患者提前,两组间比较差异有统计学意义(P0.05)。(4)益生菌组患者术后腹泻发生率为8.0%,低于对照组患者32.0%,差异有统计学意义(P0.05)。(5)两组研究对象在术后胰瘘、胃排空延迟、住院时间及住院花费等方面未见明显差异(P0.05)。结论:(1)术前应用益生菌能够降低胰十二指肠切除术患者术后感染并发症的发生,减少术后抗生素的使用时间。(2)术前应用益生菌有助于胰十二指肠切除术患者术后营养指标恢复,改善术后患者的营养状况。(3)术前应用益生菌能够改善胰十二指肠切除术患者术后胃肠功能,降低术后腹泻的发生率。
[Abstract]:Objective: current studies have confirmed that probiotics play an important role in promoting human health, but the clinical value of probiotics in patients undergoing abdominal surgery is still unclear, especially in patients with pancreaticoduodenectomy. The effect of oral probiotics on patients after pancreaticoduodenectomy was studied in this paper, which provided theoretical basis for the application of probiotics in perioperative period. Methods: (1) 50 patients undergoing pancreaticoduodenectomy in our hospital were randomly divided into oral probiotics group (n = 25) and blank control group (n = 25). The patients in probiotics group were given oral probiotics preparation before operation for 7 days. In the control group, no special treatment was given. (2) the incidence of postoperative infection complications was compared between the two groups. (3) the changes of blood nutrition related indexes before and after operation were recorded. (4) the time of exhaust defecation and feeding were compared between the two groups. The incidence of postoperative diarrhea in the two groups was analyzed. (5) the postoperative hospitalization time and hospitalization cost were studied in both groups. Results: (1) the incidence of postoperative infection in probiotics group was 16.0, which was lower than that in control group (44.0%). The postoperative antibiotic use time in probiotics group was (8.4 卤3.0) days shorter than that in control group (10.8 卤6.5) days, the difference was statistically significant (P0.05). (2) compared with control group. The erythrocyte count, hemoglobin, total protein and albumin were higher in oral probiotics group 12 days after operation. There was significant difference between the two groups (P0.05). (3) the time of exhaust defecation and food recovery in probiotics group was earlier than that in control group. There was significant difference between the two groups (P0.05). (4) the incidence of postoperative diarrhea in probiotics group was 8.0, which was lower than that in control group (P0.05). (5). There was no significant difference in the length of stay and the cost of hospitalization (P0.05). Conclusion: (1) preoperative application of probiotics can reduce the incidence of postoperative infection complications in patients with pancreaticoduodenectomy and reduce the time of antibiotic use. (2) preoperative application of probiotics is helpful to the recovery of postoperative nutritional indexes in patients undergoing pancreatoduodenectomy. Improve postoperative nutritional status. (3) preoperative application of probiotics can improve postoperative gastrointestinal function of patients with pancreaticoduodenectomy and reduce the incidence of postoperative diarrhea.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R656

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