枯草杆菌二联活菌肠溶胶囊防治经肝动脉化疗栓塞术后不良反应及并发症的效果评价

目的探讨枯草杆菌二联活菌肠溶胶囊对经肝动脉化疗栓塞术(TACE)术后不良反应及并发症的防治作用。方法选取2012年1月-2013年12月大连大学附属中山医院收治的择期进行TACE的肝细胞癌患者239例,随机分为试验组(n=111)与对照组(n=128)。其中试验组于术前3 d给予口服枯草杆菌二联活菌肠溶胶囊,对照组服用外形相同的安慰剂,比较2组TACE术后不良反应、并发症发生率及血氨水平。计量资料组间比较采用独立样本t检验,计数资料组间比较采用χ2检验。结果试验组患者发热、腹胀、便秘等不良反应发生率显著低于对照组,差异均有统计学意义(t值分别为2.728、2.561、2.026,P值均0.05);试验组患者肝脓肿、肠梗阻、自发性腹膜炎、肝性脑病等术后并发症的发生率亦显著低于对照组,差异均有统计学意义(t值分别为1.969、2.312、2.987、2.826,P值均0.05);经治疗后,与对照组相比,试验组患者血氨水平较低,差异具有统计学意义(t=1.97,P0.05)。结论枯草杆菌二联活菌肠溶胶囊作为新型活菌制剂,能够降低TACE术后患者腹部不适及血氨水平,并能够减少肝脓肿等严重并发症的发生,但相关机制尚需进一步研究。

Effect of live combined Bacillus subtilis and Enterococcus faecium enteric-coated capsules in treatment of adverse e-vents and complications after transcatheter arterial chemoembolization

Objective ToevaluatetheeffectoflivecombinedBacillussubtilisandEnterococcusfaeciumenteric-coatedcapsulesinthepre-ventionandtreatmentofadverseeventsandcomplicationsaftertranscatheterarterialchemoembolization(TACE).Methods Atotalof239 patients who were diagnosed with hepatocellular carcinoma and treated with TACE from January 2012 to December 2013 were randomly divided into experimental group (n=111)and control group (n=128).The patients in the experimental group were orally given live combined Bacil-lus subtilis and Enterococcus faecium enteric-coated capsules 3 days before surgery,and the patients in the control group were given placebo with the same appearance.The adverse events,incidence of complications,and blood ammonia level after TACE were compared between the two groups.Independent-samples t-test was performed for comparison of continuous data between the two groups,and chi-square test was performedforcomparisonofcategoricaldata.Results Comparedwiththoseinthecontrolgroup,thepatientsintheexperimentalgrouphada significantly lower incidence of adverse events such as pyrexia,abdominal distension,and constipation (t=2.728,2.561,and 2.026,respec-tively;all P<0.05);meanwhile,the patients in the experimental group had a significantly lower incidence of postoperative complications such as liver abscess,ileus,spontaneous bacterial peritonitis,and hepatic encephalopathy than those in the control group (t =1.969,2.312, 2.987,and 2.826,respectively;all P<0.05).After treatment,the patients in the experimental group had a significantly lower blood ammo-nialevelcomparedwiththoseinthecontrolgroup(t=1.97;P<0.05).Conclusion Asanewkindoflivebacterialpreparation,Bacillus subtilis and Enterococcus faecium enteric-coated capsules can reduce abdominal discomfort and blood ammonia level after TACE,as well as the incidence of severe complications including liver abscesses,but related mechanisms need further studies.