1.The impact of perioperative intestinal microecological intervention on abdominal infection after liver transplantation
Xingbing WU ; Qingcao LI ; Caide LU
Chinese Journal of Hepatobiliary Surgery 2020;26(7):530-534
Objective:To study the impact of perioperative intestinal microecological intervention on abdominal infection after liver transplantation.Method:Fifty patients who underwent liver transplantation at the Department of Hepatobiliary Surgery, Ningbo Medical Center Lihuili Hospital from June 2017 to June 2019 were retrospectively studied. There were 34 males and 16 females. The average age was 47 years. These patients were divided into two groups using the method of non-randomized concurrent control. One group formed the perioperative intestinal microbiological intervention group, while the other group served as the conventional treatment control group. There were 25 patients in each group. The preoperative and postoperative intestinal flora and the occurrence of postoperative abdominal infection of the two groups were compared.Results:After operation in both groups, enterococci increased, enterobacteriaceae decreased, while non-fermenting bacteria and candida showed no significant changes. In the intervention group, the counts of enterobacter, enterococcus and candida were significantly lower than the control group on day 15 after operation ( P<0.05). The contents of bifidobacteria and lactobacillus in the intervention group were significantly higher than that in the control group on days 7 and 15 after operation. On the other hand, the contents of enterobacter on day 7 and enterococcus on day 15 after operation in the intervention group were significantly lower than the control group ( P<0.05). The intestinal flora of the two groups were imbalanced before liver transplantation. The ratio of bifidobacterium / enterobacteriaceae in the intervention group was significantly higher than the control group on day 7 and 15 after operation ( P<0.05). The incidence of intestinal bacterial translocation in the control group was 32.0% (8/25), with 6 patients diagnosed to have abdominal infection caused by intestinal bacterial translocation. The incidence of intestinal bacterial translocation was 8% (2/25) in the intervention group, with 1 patient diagnosed to have abdominal infection caused by intestinal bacterial translocation. The incidence of bacterial translocation in the intervention group was significantly lower than the control group ( P<0.05). There were no significant differences in the incidences in the intestinal bacterial translocation and abdominal infection between the two groups ( P>0.05). Conclusions:Probiotics intervention in the perioperative period of liver transplantation improved the imbalance of intestinal flora, reduced the incidence of intestinal bacterial translocation, and played a positive role in reducing abdominal infection after liver transplantation.
2.Effects of parecoxib sodium on emergence agitation for patients with liver cancer under sevoflurane anesthesia
Ping FANG ; Qingcao LI ; Lihong HU ; Jingyu WANG ; Hong YE
China Modern Doctor 2015;(22):109-112
Objective To explore the effects of parecoxib sodium on emergence agitation for patients with liver cancer under sevoflurane anesthesia. Methods A total of 76 patients received liver cancer surgery under sevoflurane anesthesia. Among them, 38 patients were assigned to the parecoxib group (P group), and the other 38 patients were assigned to the control group (C group). P group and C group were given intravenous injection of 40 mg of parecoxib and 10 μg of sevoflurane respectively 30 min before the completion of the surgery. The vital signs were observed 15 min and 30 min after the extubation, pain VAS score and agitation RS score were calculated 15 min after the extubation, and at the same time, patients' adverse effects such as nausea and vomiting, drowsiness and respiratory depression were observed. Results General data such as age, weight, height, surgery time, incision length and VAS scores between the two groups of patients were not statistically significant(P>0.05); RS scores, and incidence rate of nausea, vomiting, and drowsiness in P group were significantly lower than those in C group, and the differences were statistically significant (P<0.05);during emergence, the two groups of patients showed stable vital signs without respiratory depression. All drainage tubes were unobstructed without being compressed or distorted. Conclusion Parecoxib is effective in reducing the agi-tation of patients with liver cancer during the emergence of sevoflurane anesthesia.