Pérez Aisa Angeles, García Gavilán Mari Carmen, Alcaide García Julia, Méndez Sánchez Isabel María, Rivera Irigoin Robin, Fernández Cano Francisco, Pereda Salguero Teresa, Rivas Ruiz Francisco
Unidad de Digestivo, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España.
Unidad de Digestivo, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España.
Gastroenterol Hepatol. 2019 Jan;42(1):1-10. doi: 10.1016/j.gastrohep.2018.07.001. Epub 2018 Sep 6.
Available evidence assessing the impact of small intestinal bacterial overgrowth (SIBO) following gastrectomy is limited.
To evaluate the prevalence of SIBO after gastrectomy and its association with malnutrition. To describe the antibiotic treatment required to correct it and if nutritional status improves.
A prospective cohort study was performed at the Agencia Sanitaria Costa del Sol (Costa del Sol Health Agency) from 2012 to 2015. A hydrogen-methane breath test with oral glucose overload was performed. Demographic variables and nutritional parameters were collected at baseline and one month after effective treatment of SIBO. The antibiotic regimens and the number of treatment lines used were assessed.
Sixty gastrectomy patients were analysed, 58.3% of which were male. A sub-analysis of the curve was performed at 45min to minimise possible false positives, and SIBO was identified in 61.6% of cases. SIBO patients tended to have a lower BMI, although this trend was not statistically significant. After treatment with rifaximin, 94.6% of patients were still positive for SIBO, which fell to 85.7% after metronidazole. The rate of total antibiotic treatment failure was 67.6%. No statistically significant changes were found in nutritional parameters after treatment.
SIBO was identified in 61.6% of patients after gastrectomy. No correlation was found with any malnutrition parameter. Rifaximin and metronidazole were found to be largely ineffective in eradicating SIBO. When treatment was effective, the impact on malnutrition was negligible and may have been associated with other factors.
评估胃切除术后小肠细菌过度生长（SIBO）影响的现有证据有限。
评估胃切除术后SIBO的患病率及其与营养不良的关联。描述纠正SIBO所需的抗生素治疗以及营养状况是否改善。
2012年至2015年在太阳海岸卫生机构（Agencia Sanitaria Costa del Sol）进行了一项前瞻性队列研究。进行了口服葡萄糖负荷后的氢-甲烷呼气试验。在基线和SIBO有效治疗后1个月收集人口统计学变量和营养参数。评估了抗生素治疗方案和使用的治疗线数。
分析了60例胃切除患者，其中58.3%为男性。在45分钟时进行曲线亚分析以尽量减少可能的假阳性，61.6%的病例中发现SIBO。SIBO患者的BMI往往较低，尽管这一趋势无统计学意义。用利福昔明治疗后，94.6%的患者SIBO仍为阳性，甲硝唑治疗后降至85.7%。抗生素治疗总失败率为67.6%。治疗后营养参数未发现有统计学意义的变化。
胃切除术后61.6%的患者发现SIBO。未发现与任何营养不良参数相关。发现利福昔明和甲硝唑在根除SIBO方面基本无效。当治疗有效时，对营养不良的影响可忽略不计，可能与其他因素有关。
