摘要
目的探讨术前选择性消化道去污染(selecteddecontaminationofthedigestivetract,SDD)对体外循环(cardiopul-monarybypass,CPB)风湿性心脏病瓣膜置换术患者围术期肠道通透性及内毒素易位的影响,为减轻内毒素血症、预防感染制定护理对策提供依据。方法选择风湿性心脏病瓣膜置换术CPB患者30例,随机分为对照组和SDD组。对照组行常规术前肠道准备,即饮食准备和清洁灌肠;SDD组在常规准备的基础上行SDD干预。检测两组患者肠道菌群、D-乳酸和血浆内毒素水平的变化。结果两组患者在经历CPB后循环内毒素水平皆显著增高(P<0.05);但与对照组相比,SDD组患者D-乳酸水平、肠道革兰阴性(G-)菌群数量和循环内毒素水平明显降低(P<0.05)。结论SDD是保护肠黏膜屏障、降低肠道通透性和去除肠道潜在致病菌、减少内毒素易位的有效肠道准备方法。
Objective To evaluate the effect of preoperative selected decontamination of the digestive tract on intestinal permeability and endotoxin translocation in patients with rheumatic heart disease who underwent valve replacement with cardiopulmonary bypass and discuss nursing strategy in such patients. Methods Thirty adults were randomly divided into control group and SDD group. The patients in control group were provided with routine preoperative preparation while those in SDD group received oral administration of Tobramycin (100 mg) , Garlicin (40 mg) and Lactulose (10 ml) three times daily in addition to routine preoperative preparation. Intestinal flora were detected. Plasma endotoxin level and D lactate were measured at four points. Results Endotoxin level rose significantly in CPB patients of both groups( P < 0. 05 ). The amount of E. coli, endotoxin level and D-lactate decreased significantly in SDD group compared with those of control group(P<0.05). Conclusion SDD is an effective regimen of decreasing intestinal G, intestinal permeability and endotoxin translocation, and should be recommended as a daily routine of nursing care.
出处
《解放军护理杂志》
2005年第2期13-15,共3页
Nursing Journal of Chinese People's Liberation Army
关键词
内毒素
患者
肠道通透性
对照组
消化道去污染
易位
CPB
水平
结论
选择性
selected decontamination of the digestive tract
endotoxin
translocation
cardiopulmonary bypass
bowel preparation
