Effect Of Bifidobacterium Trifecta On Postoperative Recovery Of Patients With Acute Diffuse Peritonitis Caused By Upper Gastrointestinal Perforation

objective:To investigate the safety and effectiveness of bifidobacterium triple live bacteria preparation for postoperative recovery of patients with upper gastrointestinal perforation,and to study whether it can promote better and faster postoperative recovery of patients.By comparing the percentage of leukocytes,neutrophils,CRP,PCT and il-6 at the same time point,we evaluated whether the use of bifidobacteria trifectant could reduce the systemic inflammatory response compared with the use of no bifidobacteria trifectant.Through the comparison of CD3+,CD4+,CD8+ T cell values and the ratio of CD4+/CD8+ at the same time point,the author evaluated whether the use of bifidobacterium trifecta could better improve the immune function of patients compared with the use of no bifidobacterium trifecta.The comparison of postoperative exhaust time,length of stay and incidence of complications was used to evaluate whether the use of bifidobacteria trifecta could better promote patients' rapid postoperative recovery than the use of no bifidobacteria trifecta.Methods: Patients with acute upper gastrointestinal perforation who were admitted to anqing hospital affiliated to anhui medical university from May 2018 to June 2019 were selected.The patients were included into the observation group and the control group by random number table method,with 30 patients in each group.Foundation treatment plan includes using stomach tube with jejunum nutrition tube line gastrointestinal decompression,forbidden line through the mouth to eat,emergency laparoscopic repair of perforation,anti-infection,acid suppression,intestinal nutrition support inside and outside,adjust the water electrolyte and acid-base balance,etc.,required in patients with early postoperative ambulation.Patients in the control group received basic treatment,and patients in the observation group were treated with bifidobacterium triplex live bacteria on the basis of conventional treatment.Blood routine test,CRP,PCT,il-6,CD3+,CD4+,and CD8+T cell ratios were measured before and after surgery at day 1,4,and 7,and the length of hospital stay,exhaust and defecation time,and whether complications occurred were recorded.Results: Preoperative and postoperative day 1,two groups of patients the WBC and neutrophils ratio,CRP and PCT,IL-6 horizontal comparison,there was no statistically significant difference(p > 0.05);On the 4th day after surgery,the WBC and neutrophil ratio,CRP,PCT and il-6 levels of the observation group were lower than those of the control group,but the difference was not statistically significant(P>,0.05).On the 7th day after the operation,the serum WBC and neutrophil ratios in the two groups were basically restored to normal,with no statistically significant difference(P>,0.05).The levels of CRP,PCT and il-6 in the observation group were lower than those in the control group,and the difference was statistically significant(P < 0.05).Preoperative and postoperative day 1,two groups of peripheral blood T lymphocyte subsets of patients with horizontal comparison,there was no statistically significant difference(P > 0.05).On the 4th and 7th days after surgery,the ratios of CD3+,CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group,and the ratios of CD8+ and CD8+T lymphocytes in the observation group were lower than those in the control group,with statistically significant differences(P < 0.05).In the process of this study,two groups of patients with only mild complications(?,?).After treatment,the average length of stay and postoperative complications in the observation group were less than those in the control group,and the difference was statistically significant(P < 0.05).The mean exhaust time of patients in the observation group was less than that in the control group,but the difference was not statistically significant(P>,0.05).Conclusion: For patients with upper gastrointestinal perforation,bifidobacteria triplex live bacteria preparation can enhance the immune function of patients,reduce systemic inflammatory response,enhance intestinal barrier,promote the rapid recovery of intestinal function,and improve the therapeutic effect.It is an effective method to treat patients with upper gastrointestinal perforation with bifidobacterium triplex viable bacteria,which is worthy of further clinical research and application.