| Objective:To study the effects of oral intestinal probiotics on postoperative changes of blood lipid and bile composition in patients with gallstones.Methods:Choosing 2020-June to December 2020,the second affiliated hospital of kunming medical university during outpatient surgery treatment of gallbladder calculi secondary to 50 cases of patients with cholelithiasis and CBD stones,with ultrasound and MRI diagnosis report as A diagnostic basis,feasibility,preliminary judgment during outpatient surgery with intention and surgery to treat disease patients according to the method of random number list of the pointer can be divided into:Group A(oral postoperative intestinal probiotics)25 cases,25 cases of Group B(blank control Group).There were 30 males and 20 females,all patients with preoperative day or outpatient service for the first time line and biochemical test.The control Group and the experimental Group underwent preoperative auxiliary examination after admission,and the anesthesiologists examined the patients to verify that there were no contraindications to surgery.Laparoscopic cholecystectomy combined with choledocholithotomy through cystic duct under elective general anesthesia.T tubes were indwered after surgery,and bile from the common bile duct was extracted intraoperatively,and the patients were safely returned to the ward after surgery.The intervention Group was given intestinal probiotics orally on the second morning after the operation,while the control Group was not given any intervention.Patients were told to avoid high-fat diet after the operation until they returned to the hospital for re-examination on the fourth week after the operation.The common bile duct bile was extracted again in the experimental Group,and biochemical tests were performed again for all patients.Results1.General information of patients:Choose between June 2020 in December 2020,the second affiliated hospital of kunming medical university during outpatient surgery treatment of gallbladder calculi with 50 cases of patients with cholelithiasis and CBD stones,ultrasound and MRI diagnosis report as diagnosis,patients according to the method of random number list is divided into:Group A(oral postoperative intestinal probiotics)25 cases,25 cases of Group B(blank control Group),were included in this study of 50 patients with standard.There were 30 males and 20 females and no statistical differences in age,gender,body mass index(BMI)and surgical method between 2 Groups(P>0.05).(See Table 7)2.Analysis of serum biochemical indexes:Total bile acid(TBA):Preoperative 5.33±2.92μmol/L in group A and postoperative 3.35±2.21μmol/L in group A,P<0.05 before and after the comparison,the difference was statistically significant.Group B was 5.211±2.47μmol/L before surgery and 5.07±2.17μmol/L after surgery.The P>0.05 in group B before and after surgery was not statistically significant.Preoperative comparison between group A and B showed P>0.05,and the difference was not statistically significant.The postoperative comparison between group A and B was P<0.05,and the difference was statistically significant.Total cholesterol(TCHOL):Before operation:15.61±4.43ng/ml in group A,after operation:12.65± 3.62ng/ml,before and after comparison of group A P<0.05,the difference was statistically significant.Before operation:14.48±4.09 ng/ml in group B;after operation:16.24±3.57 ng/ml;before and after operation:P>0.05 in group B,the difference was not statistically significant.Preoperative comparison between group A and B showed P>0.05,and the difference was not statistically significant.The postoperative comparison between group A and B was P<0.05,and the difference was statistically significant.Triglyceride(TG):Group A:1.07±0.40mmol/L before surgery,0.831 0.32mmol/L after surgery,P<0.05 before and after Group A,the difference was statistically significant.Group B was 1.04±0.41mmol/L preoperatively and 1.08±0.37mmol/L postoperatively.Before and after the comparison of Group B P>0.05,the difference was not statistically significant;before and after the comparison of Group A and B,P BBB>05,the difference was not statistically significant.The postoperative comparison between Group A and B was P<0.05,and the difference was statistically significant.High density lipoprotein(HDL-C):1.34±0.29mmol/L in Group A before surgery,1.49±0.22mmol/L in Group A after surgery,P<0.05,the difference was statistically significant.Before operation:1.39±0.28mmol/L in Group B,after operation:1.21±0.56mmol/L;before and after operation:P>0.05 in Group B,the difference was not statistically significant.Preoperative comparison between Group A and B showed P>0.05,and the difference was not statistically significant.The postoperative comparison between Group A and B was P<0.05,and the difference was statistically significant.ApoAl:Preoperative:1.36±0.34g/L in Group A,postoperative:1.37±0.33g/L,P>0.05 in Group A,the difference was not statistically significant.Preoperative:1.38±0.34g/L in Group B,postoperative:1.47±0.28g/L,P>0.05 in Group B,the difference was not statistically significant.Preoperative and postoperative comparison between Group A and B showed P>0.05,and the difference was not statistically significant.Low density lipoprotein(LDL-C):3.40±1.29mmol/L,before operation in Group A,3.25±1.28mmol/L after operation;P>0.05 in Group A,and the difference was not statistically significant.Preoperative:3.34±1.28mmol/L in Group B,postoperative:3.24±1.19mmol/L,P>0.05 in Group B,the difference was not statistically significant.Preoperative and postoperative comparison between Group A and B showed P>0.05,and the difference was not statistically significant.Very low density lipoprotein(VLDL-C):Preoperative:0.94±0.31 mmol/L in Group A,postoperative:0.98±0.33mmol/L,P>0.05 in Group A,the difference was not statistically significant.Before operation:0.90±0.31 mmol/L in Group B,after operation:0.95±0.27mmol/L,P>0.05 in Group B,the difference was not statistically significant.Preoperative and postoperative comparison between Group A and Group B showed P>0.05,and the difference was not statistically significant.3.Bile component index analysisTotal bile acid(TBA):124.30± 10.23 ng L in Group A before surgery,133.57±7.00 ng/L in Group A after surgery,P<0.05,the difference was statistically significant.Before operation:128.73±11.15 ng/L in Group B;after operation:126.07± 10.46 ng/L;before and after operation:P>0.05 in Group B,the difference was not statistically significant.Preoperative comparison between Group A and B showed P>0.05,and the difference was not statistically significant.The postoperative comparison between Group A and B was P<0.05,and the difference was statistically significant.Total cholesterol(TCHOL):15.61±4.43 ng/L before Group A,12.65±3.62 ng/L after Group A,P<0.05 before and after Group A,the difference was statistically significant.Before operation:14.48±4.09 ng/L in Group B;after operation:16.24±3.57 ng/L;before and after operation:P>0.05 in Group B;the difference was not statistically significant.Preoperative comparison between Group A and B showed P>0.05,and the difference was not statistically significant.The postoperative comparison between Group A and B was P<0.05,and the difference was statistically significant.Cholic acid(CA):103.78±21.45ng/ml before Group A,80.83±14.44ng/ml after Group A,P<0.05 before and after Group A,the difference was statistically significant.Before operation:96.72±16.23ng/ml in Group B;after operation:85.52±19.91 ng/ml;before and after operation:P>0.05 in Group B,the difference was not statistically significant.Preoperative comparison between Group A and B showed P>0.05,and the difference was not statistically significant.The postoperative>0.05 between Group A and B was not statistically significant.Deoxycholic acid(DCA):16.48±4.32ng/ml before Group A,11.66±3.79ng/ml after Group A,P<0.05 before and after Group A,the difference was statistically significant.Before operation:14.68±3.62ng/ml in Group B;after operation:14.56±5.61ng/ml;before and after operation:P>0.05 in Group B,the difference was not statistically significant.Preoperative comparison between Group A and B showed P>0.05,and the difference was not statistically significant.The postoperative comparison between Group A and B was P<0.05,and the difference was statistically significant.4.GIQLI score:Postoperative average score of Group A:111.40±23.70,Group B:97.12±13.80,the score of Group A was higher than that of Group B,and the comparison between Groups was P<0.05,both of which were statistically significant.In conclusion,oral administration of intestinal probiotics can improve postoperative blood lipid level and bile composition in patients with gallstone,accelerate cholesterol excretion,improve postoperative GIQLI score in patients with gallstone,and improve postoperative quality of life of patients.[Conclusions]1.Postoperative administration of intestinal probiotics in patients with gallstone can reduce serum TBA,TCHOL and TG levels and increase HDL-C levels.2.Postoperative oral administration of intestinal probiotics in patients with gallstone can improve the bile composition of patients and accelerate cholesterol metabolism. |
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