PEC途径行粪菌移植加肠内营养治疗复发性溃疡性结肠炎

发布时间：2018-05-05 05:22

本文选题：溃疡性结肠炎 + 经皮内镜下盲肠造口置管术　；参考：《肠外与肠内营养》2015年01期

【摘要】：目的:探讨通过经皮内镜下盲肠造口置管术(PEC)途径行粪菌移植治疗溃疡性结肠炎(UC)的可行性及实施流程。方法:男性病人,24岁,因间断腹痛伴黏液血便6年以UC治疗无效收住入院。入院后经PEC行粪菌移植,观察病人症状、体征、粪便性状及习惯变化、肠内营养(EN)耐受情况以及结肠镜下表现的变化。结果:住院期间每天1次粪菌移植,连续行30次。出院后按医院内同样的程序每天1次连续行10次粪菌移植。住院期间,粪菌移植治疗后排便次数及粪便性状逐渐正常;粪菌移植1周后已恢复全EN,1个月后开始过渡至口服饮食,内镜下可见明显好转。出院后病人逐渐恢复完全口服饮食,排便正常,1次/d。粪菌移植结束后2个月复查结肠镜未见明显病变,予以拔除PEC。随访3个月,病人日常口服饮食,排成形粪便每天1次,无腹痛、腹泻或便血等症状。结论:经PEC置管后行粪菌移植病人能耐受长时间的治疗,特别是可在家庭中安全实施,初步治疗及短期随访也证实其安全性和有效性。
[Abstract]:Objective: to explore the feasibility and procedure of transplants of fecal bacteria in the treatment of ulcerative colitis (UC) by percutaneous endoscopic caecostomy (PEC). Methods: a 24-year-old male patient with intermittent abdominal pain and mucous stool was admitted to hospital for 6 years with ineffective UC treatment. After admission to PEC, fecal bacteria transplantation was performed to observe the changes of symptoms, signs, fecal traits and habits, enteral nutrition (en) tolerance and colonoscopy. Results: there were 30 consecutive transplants of fecal bacteria once a day during hospitalization. After discharge, 10 consecutive transplants were performed once a day according to the same procedure in the hospital. During hospitalization, defecation times and fecal traits were normal after the treatment of fecal bacteria transplantation, and the total ENN was restored after 1 week of defecation bacteria transplantation, and the transition to oral diet began after 1 month, which showed obvious improvement under the endoscope. After discharge, the patient gradually returned to a complete oral diet with normal defecation once a day. Two months after fecal bacteria transplantation, no obvious changes were found in colonoscopy, and PECs were removed. The patients were followed up for 3 months. The patients were fed orally and excreted once a day without abdominal pain, diarrhea or hematochezia. Conclusion: patients with fecal bacteria transplantation after PEC catheterization can tolerate long-term treatment, especially in the home. The preliminary treatment and short-term follow-up also proved its safety and effectiveness. [WT5HZ] [WT5 "HZ] [WT5" BZ] [WT5 "BZ] [WT5BZ]
【作者单位】：南京军区南京总医院解放军普通外科研究所;
【分类号】：R574.62

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