【摘要】 目的:探讨酪酸梭菌联合抗菌药物对急性阑尾炎患者腹腔镜术后炎症因子及胃肠功能的影响。方法:选择2014年1月-2015年1月我院拟行腹腔镜手术治疗的急性阑尾炎患者102例,根据入院单双号分为观察组和对照组,各51例。对照组患者术后给予注射用头孢呋辛钠、甲硝唑葡萄糖注射液、头孢克肟分散片抗感染治疗;观察组患者术后在对照组基础上加用酪酸梭菌活菌胶囊1 260 mg,tid,连续服用3 d。比较两组患者术前及术后3 d血清炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、C反应蛋白(CRP)]、胃动素(GAS)、胃泌素(MTL)水平,并记录两组患者胃肠功能恢复时间(肠鸣音出现时间、首次肛门排气时间、术后首次排便时间)及并发症发生情况。结果:术前,两组患者血清炎症因子、GAS、MTL水平比较,差异均无统计学意义(P>0.05);术后3 d,两组患者TNF-α、IL-6、CRP水平显著降低,GAS、MTL水平显著升高,且观察组上述指标显著优于对照组,差异均有统计学意义(P<0.05)。观察组患者肠鸣音出现时间、首次肛门排气时间、术后首次排便时间均明显短于对照组,差异均有统计学意义(P<0.05)。观察组患者并发症发生率为3.92%,显著低于对照组的15.69%,差异有统计学意义(P<0.05)。结论:酪酸梭菌联合抗菌药物能有效缓解急性阑尾炎腹腔镜手术患者炎症状态,促进胃肠功能恢复,减少并发症发生。更多还原

【Abstract】 OBJECTIVE:To investigate the effects of clostridium butyricum combined with antibiotics on inflammatory factors and gastrointestinal function of patients with acute appendicitis after laparoscopic surgery. METHODS:A total of 102 patients with acute appendicitis undergoing laparoscopic surgery in our hospital during Jan. 2014-Jan. 2015 were divided into observation group and control group according to odd-even admission number,with 51 cases in each group. Control group was given Cefuroxime sodium for injection,Metronidazole injection and Cefixime dispersible tablets for anti-infective therapy after surgery. Observation group was additionally given Clostridium butyricum capsule 1 260 mg,tid,for consecutive 3 d,on the basis of control group. The levels of serum inflammatory factors(TNF-α,IL-6),gastrin(GAS)and motilin(MTL)were compared between 2 groups before surgery and 3 d after surgery. The time of gastrointestinal function recovery(the time of bowel sounds,the time of first flatus,the time of postoperative first defecation) and the occurrence of compliance were recorded in 2 groups. RESULTS:Before surgery,there was no statistical significance in the levels of serum inflammatory and GAS,MTL factors between 2 groups(P>0.05). 3 d after surgery,the levels of TNF-α,IL-6 and CRP in 2 groups were decreased significantly,while the levels of GAS and MTL were increased significantly;above indexes of observation group were significantly better than those of control group,with statistical significance(P<0.05). The time of bowel sounds,the time of first flatus and the time of postoperative first defecation in observation group were significantly shorter than control group,with statistical significance(P<0.05). The incidence of complications in observation group was 3.92%,which was significantly lower than 15.69% of control group(P<0.05). CONCLUSIONS:Clostridium butyricum combined with antibiotics can effectively relieve inflammatory state of patients with acute appendicitis after laparoscopic surgery,promote gastrointestinal function recovery,and reduce the occurrence of complications.更多还原