呼气氢试验对恶性梗阻性黄疸患者围手术期小肠细菌移位的判断价值

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1、第17卷第2期中国普通外科杂志Vo.l17
No.22008年2月ChineseJournalofGeneralSurgeryFeb.
2008

文章编号:1005-6947(2008)02-0145-03
基础研究
呼气氢试验对恶性梗阻性黄疸患者围手术期小肠细菌移位的判断价值沈裕厚,孙君军,刘伟峰,常彦超,刘玉秋,钱俊甫,李俊娜(河南科技大学第一附属医院肝胆胰外科,河南洛阳471003)

摘要:目的
研究恶性梗阻性黄疸患者围手术期血浆内毒素(PE)的动态变化,应用呼气氢试验(HBT)判断小肠细菌的移位及其意义。方法
选择38例

2、可行手术治疗的恶性梗阻性黄疸患者为试验组(A组),健康受试者30例为对照组(B组)。观察A组患者术前、术后PE的变化及HBT的结果,并与B组进行比较。结果
入院时A组PE水平为(0.69
0.22)EU/mL(EndotoxinUnitpermL),与B组(0.17
0.05)EU/mL相比差异有显著性(P<0.01);A组术前1dPE下降不明显(P>0.05),术后下降显著(P<0.05)。A组入院时,术前1d,术后3,7,14dHBT阳性率分别为86.8%,73.7%,39.5%,21.1%和7.9%;B组阳性率为6.7%。A组

3、入院时与B组相比差异有显著性(P<0.05)。A组术后3,7d与术前1d相比较差异有显著性(P<0.05)。结论
恶性梗阻性黄疸患者存在肠道细菌移位,合并不同程度的内毒素血症。呼气氢试验是判断恶性黄疸患者围手术期小肠细菌移位的较好指标。[中国普通外科杂志,2008,17(2):145-147]关键词:黄疸,阻塞性;内毒素血症;呼气氢试验;细菌移位中图分类号:R735.8-9



文献标识码:AThevalueofhydrogenbreathtestinjudgingofbacterialtranslocationintheperi

4、operativeperiodofpatientswithmalignantobstructivejaundiceSHENYuhou,SUNJunjun,LIUWeifeng,CHANGYanchao,LIUYuqiu,QIANJunfu,LIJunna(DepartmentofHepatopancreatobiliarySurgery,TheFirstAffiliatedHospitalofHenanUniversityofScienceandTechnology,Luoyang,Henan471003,China)Abstrac

5、t:Objective
Tostudythedynamicsofplasmaendotoxin(PE)levelsintheperioperativeperiodofpatientswithmalignantobstructivejaundice,andthesignificanceofhydrogenbreathtest(HBT)injudgingofsmallintestinalbacterialtranslocation.Methods
Thirty
eightpatientswithmalignantobstructivej

6、aundicewhoweresuitableforoperation,weredefinedastreatmentgroup(groupA,n=38)and30healthyindividualsweredefinedascontrolgroup(groupB,n=30).ThechangesofPElevelsandtheresultsofHBTduringtheperioperartiveperiodwereobservedingroupA,andcomparedwithgroupB.Results
Onadmissiontoh

7、ospital,thePElevelingroupA[(0.69
0.22)EU/mL]andgroupB[(0.17
0.05)EU/mL]wassignificantdifference(P<0.01).Duringthe1dpreoperativeperiod,thePElevelsdecreasedalittle(P>0.05),butitdecreasedsignificantlyafteroperation(allP<0.05).ThepositiveratesofHBTingroupAatadmission,1dpre

8、operativeand3d,7dand14dafteroperation,was86.8%,73.7%,39.5%,21.1%and7.9%;anditwas6.7%ingroupB.Thedifferencewassignific