Wang Song, Wang Mao-long, Li Yu, Zhou Yan-bing, Wang Dong-sheng
Department of General Surgery, The Affiliated Hospital of Qingdao University Medical College, Qingdao, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2012 Jun;15(6):570-3.
To investigate the effects of the different treatment on gut flora in patients with rectal cancer in the perioperative period.
A total of 64 patients with rectal cancer were prospectively enrolled from July 2010 to June 2011 at the Qingdao University Medical College Affiliated Hospital, and randomized into 8 groups receiving different treatments in perioperative period. Factorial design was used to study three factors including preoperative bowel preparation, antibiotics use, and postoperative fasting. Patients were randomized into 8 groups with 8 patients in each group using the random digit table. Preoperative and postoperative stool specimens were collected and diluted, which were transferred to selective medium. Bacteria counts were calculated after 48 hours of culture under constant temperature. The changes in gut flora between the different groups were compared.
Compared to the preoperative parameters, total bacteria, Bifidobacterium, Peptostreptococcus, Lactobacillus, Bacteroides, Enterococcus decreased significantly(P<0.05), while the E.coli count increased significantly. The bacillus/coccus ratio was significantly imbalanced. Preoperative bowel preparation, oral antibiotics, and postoperative fasting were all predominant factors associated with gut flora(all P<0.05). Compared with the antibiotic restriction group, Bacteroides, Enterococcus, Lactobacillus, Peptostreptococcus, and total bacteria count were reduced significantly, and the bacillus/coccus ratio increased in the non-antibiotics restriction group(P<0.05). In the bowel preparation group, Bacteroides, Peptostreptococcus, total bacteria count, and the bacillus/coccus ratio decreased(P<0.05). In the postoperative fasting group, Bacteroides, Enterococcus, total bacteria, and bacillus/coccus ratio decreased(P<0.05).
Antibiotics, bowel preparation, and postoperative fasting can affect the number and ratio of gut flora in patients with rectal cancer in the perioperative period, leading to dysbacteriosis.
探讨不同治疗方法对直肠癌患者围手术期肠道菌群的影响。
2010年7月至2011年6月前瞻性纳入青岛大学医学院附属医院64例直肠癌患者，随机分为8组，在围手术期接受不同治疗。采用析因设计研究术前肠道准备、抗生素使用和术后禁食三个因素。使用随机数字表将患者随机分为8组，每组8例。收集术前和术后粪便标本并稀释，转接至选择性培养基。恒温培养48小时后计算细菌计数。比较不同组之间肠道菌群的变化。
与术前参数相比，总细菌、双歧杆菌、消化链球菌、乳酸杆菌、拟杆菌、肠球菌显著减少（P<0.05），而大肠杆菌计数显著增加。杆菌/球菌比例明显失衡。术前肠道准备、口服抗生素和术后禁食均是与肠道菌群相关的主要因素（均P<0.05）。与抗生素限制组相比，非抗生素限制组拟杆菌、肠球菌、乳酸杆菌、消化链球菌和总细菌计数显著降低，杆菌/球菌比例升高（P<0.05）。在肠道准备组中，拟杆菌、消化链球菌、总细菌计数和杆菌/球菌比例降低（P<0.05）。在术后禁食组中，拟杆菌、肠球菌、总细菌和杆菌/球菌比例降低（P<0.05）。
抗生素、肠道准备和术后禁食可影响直肠癌患者围手术期肠道菌群的数量和比例，导致菌群失调。
