Sir Charles Gairdner hospital, Hospital Ave, Nedlands, Australia;
Swan district hospital, Australia.
Hepatobiliary Surg Nutr. 2013 Jun;2(3):142-7. doi: 10.3978/j.issn.2304-3881.2013.06.05.
Although liver transplantation has been widely practised, post-operative bacterial infection is still a frequent complication which contributed to an increased risk of fatality. There were studies on preoperative use of probiotics for liver transplant patients and acquired reduction in postoperative sepsis and wound infection, but the relevant clinical experience with pre- and probiotics is still limited.
This study is to assess fibre and probiotic use aimed at preventing bacterial sepsis and wound complications in patients undergoing liver transplantation.
There were a total of sixty-seven adult patients scheduled for liver transplantation were included in a public teaching hospital. From January to December 2011, 34 continuous patients following liver transplantation were put on fibre + probiotics. In retrospectively, from January to December 2010, 33 continuous patients were collected as a control group and they were only received fibre post operation. The incidence of bacterial infections was compared in patients receiving either fibre and lactobacillus or fibre only. Statistical analysis was performed using SPSS 15. The t test, fisher's and chi- square test was used to compare discrete variables.
In summary, in the analysis of 67 liver transplant recipients, 8.8% group A patients developed infections compared to 30.3% group B patients. The difference between groups A and B was statistically significant in both cases. In addition, the duration of antibiotic therapy was significantly shorter in the lactobacillus-group. Wound infection was the most frequent infections and enterococci the most frequently isolated bacteria. Fibre and lactobacilli were well tolerated in most cases. The operating time, amount of intra- and post-operatively transfused units of blood, fresh frozen plasma and albumin did not differ significantly between the groups.
Combined fibre and probiotics could lower the incidence of bacterial infections and shorten the duration of antibiotic therapy following liver transplantation in comparison to conventional nutrition. In contrast to antibiotics, it is relatively cheap and does not cause resistant strains or serious side effects.
尽管肝移植已广泛应用，但术后细菌感染仍是常见并发症，增加了死亡风险。有研究表明，肝移植患者术前使用益生菌可降低术后败血症和伤口感染的风险，但关于益生菌和预益生菌的相关临床经验仍然有限。
本研究旨在评估纤维和益生菌的使用，以预防肝移植患者发生细菌性败血症和伤口并发症。
共有 67 名成年肝移植患者纳入本研究，均来自一所公立教学医院。2011 年 1 月至 12 月期间，34 名连续肝移植患者术后给予纤维+益生菌。回顾性分析 2010 年 1 月至 12 月期间的 33 名连续肝移植患者，他们仅在术后给予纤维。比较接受纤维和嗜酸乳杆菌或仅纤维的患者的细菌感染发生率。使用 SPSS 15 进行统计分析。使用 t 检验、Fisher 确切概率法和卡方检验比较离散变量。
在 67 例肝移植受者的分析中，A 组 8.8%的患者发生感染，B 组 30.3%的患者发生感染。两组之间的差异具有统计学意义。此外，嗜酸乳杆菌组的抗生素治疗时间明显缩短。伤口感染是最常见的感染，肠球菌是最常分离的细菌。纤维和嗜酸乳杆菌在大多数情况下均耐受良好。两组患者的手术时间、术中及术后输血量、新鲜冰冻血浆和白蛋白量无显著差异。
与常规营养相比，联合使用纤维和益生菌可降低肝移植后细菌感染的发生率，并缩短抗生素治疗时间。与抗生素相比，它相对便宜，不会产生耐药菌株或严重的副作用。
