Xu Qingwen, Xu Pengyuan, Cen Yunyun, Li Weiming
Second Ward of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, P.R. China.
Oncol Lett. 2019 Jul;18(1):694-698. doi: 10.3892/ol.2019.10336. Epub 2019 May 8.
The effects of preoperative oral administration of glucose solution combined with postoperative probiotics on inflammation and intestinal barrier function in patients after colorectal cancer surgery were observed. Sixty patients treated and scheduled to undergo radical resection of colorectal cancer in The Second Affiliated Hospital of Kunming Medical University from March 2017 to December 2017 were selected and randomly divided into the glucose solution group (n=30) and combined probiotics group (n=30). Patients in both groups took orally 12.5% glucose solution before surgery, and those in the combined probiotics group received bifidus-triple viable preparation every day for 7 consecutive days. Changes in endotoxin, insulin-like growth factor-I (IGF-I) concentration, white blood cell count (WBC), C-reactive protein (CRP), D-lactic acid and urinary lactulose/mannitol (L/M) were detected before surgery and at 1, 3 and 7 days after surgery. The general condition was observed and changes in intestinal florae were compared between the two groups. The body temperature was measured every 4 h with an electronic thermometer, and the duration of fever was recorded (from the first day after operation to the time with normal body temperature after operation, axillary temperature <37.4°C), and the average heart rate was recorded by the ECG monitor. In addition, the time of the first anal exsufflation (the time from the beginning of the operation to the first anal exsufflation) was recorded. In the combined probiotics group, the plasma endotoxin, IGF-I concentration, D-lactic acid and urinary L/M levels were significantly lower than those in the glucose solution group (P<0.05). Moreover, the duration of postoperative fever, average heart rate at 7 days after surgery as well as WBC and CRP clinical indexes were obviously shorter and lower in the combined probiotics group than those in the glucose solution group (P<0.05). Therefore, the combined application of probiotics after surgery can effectively improve the imbalance of intestinal flora. In conclusion, preoperative oral administration of glucose solution combined with postoperative probiotics can improve the intestinal barrier function after colorectal cancer surgery, and benefit the recovery of early inflammatory response after surgery.
观察术前口服葡萄糖溶液联合术后益生菌对结直肠癌患者术后炎症及肠道屏障功能的影响。选取2017年3月至2017年12月在昆明医科大学第二附属医院接受治疗并计划行结直肠癌根治性切除术的60例患者,随机分为葡萄糖溶液组(n = 30)和益生菌联合组(n = 30)。两组患者术前均口服12.5%葡萄糖溶液,益生菌联合组患者术后连续7天每天服用双歧三联活菌制剂。分别于术前及术后1、3、7天检测内毒素、胰岛素样生长因子-I(IGF-I)浓度、白细胞计数(WBC)、C反应蛋白(CRP)、D-乳酸及尿乳果糖/甘露醇(L/M)水平。观察一般情况并比较两组肠道菌群变化。每4小时用电子体温计测量体温,记录发热持续时间(从术后第1天至术后体温恢复正常,腋温<37.4℃),并通过心电图监测仪记录平均心率。此外,记录首次肛门排气时间(从手术开始至首次肛门排气的时间)。益生菌联合组血浆内毒素、IGF-I浓度、D-乳酸及尿L/M水平均显著低于葡萄糖溶液组(P<0.05)。而且,益生菌联合组术后发热持续时间、术后7天平均心率以及WBC和CRP等临床指标均明显短于或低于葡萄糖溶液组(P<0.05)。因此,术后联合应用益生菌可有效改善肠道菌群失衡。综上所述,术前口服葡萄糖溶液联合术后益生菌可改善结直肠癌术后肠道屏障功能,有利于术后早期炎症反应的恢复。