【摘要】：目的:目前研究證實(shí),益生菌對(duì)人類健康促進(jìn)發(fā)揮著重要的作用,但是對(duì)于接受腹部外科手術(shù)的患者其臨床價(jià)值仍不明確,尤其是對(duì)胰十二指腸切除患者更是研究甚少,本文主要探究術(shù)前口服益生菌對(duì)胰十二指腸切除術(shù)后患者的影響,從而為圍手術(shù)期益生菌的應(yīng)用提供理論依據(jù)。方法:(1)選取我院普外科50名行胰十二指腸切除術(shù)患者作為研究對(duì)象,隨機(jī)分為口服益生菌組(n=25)及空白對(duì)照組(n=25),益生菌組患者術(shù)前予以口服益生菌制劑準(zhǔn)備,連續(xù)規(guī)律服用7天,而對(duì)照組不予特殊處理。(2)比較兩組患者術(shù)后感染并發(fā)癥發(fā)生情況,并統(tǒng)計(jì)兩組患者術(shù)后抗生素使用時(shí)間。(3)記錄兩組患者術(shù)前及術(shù)后血液營(yíng)養(yǎng)相關(guān)指標(biāo)變化。(4)比較兩組患者術(shù)后排氣排便及進(jìn)食時(shí)間,統(tǒng)計(jì)兩組患者術(shù)后腹瀉的發(fā)生率。(5)研究?jī)山M患者術(shù)后住院時(shí)間及住院花費(fèi)等其它指標(biāo)。結(jié)果:(1)益生菌組患者術(shù)后感染發(fā)生率為16.0%,低于對(duì)照組患者44.0%,益生菌組患者術(shù)后抗生素使用時(shí)間(8.4±3.0)天較對(duì)照組(10.8±6.5)天有所縮短,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)相對(duì)于對(duì)照組患者,口服益生菌組患者術(shù)后12日紅細(xì)胞計(jì)數(shù),血紅蛋白、總蛋白及白蛋白水平較高,兩者間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)益生菌組患者術(shù)后排氣排便時(shí)間及恢復(fù)進(jìn)食時(shí)間均較對(duì)照組患者提前,兩組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)益生菌組患者術(shù)后腹瀉發(fā)生率為8.0%,低于對(duì)照組患者32.0%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(5)兩組研究對(duì)象在術(shù)后胰瘺、胃排空延遲、住院時(shí)間及住院花費(fèi)等方面未見明顯差異(P0.05)。結(jié)論:(1)術(shù)前應(yīng)用益生菌能夠降低胰十二指腸切除術(shù)患者術(shù)后感染并發(fā)癥的發(fā)生,減少術(shù)后抗生素的使用時(shí)間。(2)術(shù)前應(yīng)用益生菌有助于胰十二指腸切除術(shù)患者術(shù)后營(yíng)養(yǎng)指標(biāo)恢復(fù),改善術(shù)后患者的營(yíng)養(yǎng)狀況。(3)術(shù)前應(yīng)用益生菌能夠改善胰十二指腸切除術(shù)患者術(shù)后胃腸功能,降低術(shù)后腹瀉的發(fā)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 鹵3.0) days shorter than that in control group (10.8 鹵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.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R656

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