目的 探讨低位直肠癌患者行腹、会阴联合直肠癌根治术(Miles术)术后口服微生态制剂对肠道菌群及粪便分泌型免疫球蛋A(SigA)含量的影响.方法 将126例Miles术后患者采用随机化原则分成观察组和对照组,每组各63例.观察组患者术后给予口服双歧三联活菌胶囊(培菲康胶囊),对照组常规治疗.分别于入院时、术后第一次排便、术后1个月收集两组患者的新鲜大便,比较两组患者的肠道菌群的改变及粪便SIgA含量.结果 术后第一次排便及术后1月观察组双歧杆菌、乳酸杆菌、拟杆菌数量显著高于对照组(P＜0.05),而肠球菌、肠杆菌数量均显著低于对照组(P＜0.05).术后1个月,观察组患者的肠道菌群与手术前相比,基本恢复(P＞0.05).术前及术后第一次排便,两组患者粪便中的SIgA水平无显著差异(P＞0.05);而术后1个月,观察组粪便SIgA含量均显著高于对照组(P＜0.05),且恢复至术前水平,而对照组仍低于术前水平.结论 直肠癌Miles手术后口服微生态制剂可有效纠正患者肠道菌群失调,并通过升高粪便SIgA含量恢复肠道屏障功能和局部免疫力.%Objective To investigate the effect of postoperative oral probiotics on intestinal flora and SIgA in patients with colorectal cancer underwent Miles surgery.Methods 126 Patients were divided into observation group (n =63) and the control group (n =63) by randomization.Observation group postoperatively oral colon triple viable capsules,the control group conventional treatment.Intestinal flora and intestinal SIgA of the two groups were observed and compared by the time on admission,the bowel movement for the first time and postoperative one month respectively.Result At the first defecation and one month after operation,the patients receiving probiotics showed significantly increased counts of intestinal Bifidobacterium,Lactobacillus and Bacteroides (P ＜0.05) and significantly lowered counts of Enterococcus and Enterobacter (P ＜ 0.05).At one month after operation the observation group flora returned to preoperative levels (P ＞0.05).Before operation and the first defecation after operation,there was no significant difference between the two groups about the SlgA levels (P ＞0.05).But at one month after operation,SIgA in stool were significantly higher in the observation group compared with the control group (P ＜ 0.05),SIgA still lower than preoperative levels in the control group.Conclusion The application of intestinal probiotics in patients with colorectal cancer after operation can effectively correct intestinal flora imbalance and raise SIgA in stool to recover intestinal mucosal barrier function and local immunity.
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