摘要
粪菌移植(FMT)作为改善菌群失调的有效方案,已在治疗复发性艰难梭菌感染中获得成功。随着对肠道菌群科学研究的深入,FMT技术也逐渐应用到各种疾病的临床治疗中,成为改善消化、内分泌、神经等多种系统疾病的新型治疗方案。但是目前,FMT的临床操作与应用并没有统一的标准。从粪菌供体的采集到菌群的移植,再到术后疗效监测,各个国家和地区对供体的选择、粪菌的制备、储存的条件、移植术式的选择、术后的监督管理都有不同的观点或标准。本文参考欧洲、亚洲多个国家和地区的临床及科研案例,结合临床经验,从供体筛选、粪菌样品的采集与存储、移植手术的选择等流程逐一进行分析,全面介绍了FMT在当前临床应用中的各种方案,探讨了不同临床操作标准之间的优缺点。另外,本文对FMT临床应用的适应证与禁忌证、术后不良事件的发生以及术后疗效监测进行了详细的介绍和评估,以期通过规范临床应用减少对患者健康的不必要损害。最后,本文总结了FMT的临床操作全流程,并给出适当的临床应用建议,以期为临床医师提供可参考的FMT操作标准。
Fecal microbiota transplantation(FMT)has been successfully used to treat recurrent C.difficile infections as an effective regimen to improve dysbiosis.With the deepening of scientific research on intestinal flora,FMT technology has also been gradually applied to clinical treatment of various diseases,and has become a new treatment solution for improving digestive,endocrine,nervous,and other systemic diseases.However,there is no unified standard for the clinical operation and application of FMT.From the collection of fecal bacteria donors to the transplantation of flora,and then to the monitoring of postoperative efficacy,the selection of donors,preparation of fecal bacteria,storage conditions,selection of transplantation techniques,and postoperative supervision and management in various countries and regions,all have different views or standards.This article refers to clinical and scientific research cases in many countries and regions in Europe and Asia,combined with clinical experience,and analyzes the procedures from donor screening,collection and storage of fecal bacteria samples,and selection of transplant surgery.The various schemes of FMT in current clinical application are comprehensively introduced,and the advantages and disadvantages between different clinical operating standards are discussed.In addition,we introduced and evaluated the indications and contraindications for the clinical application of FMT,the occurrence of postoperative adverse events,and the monitoring of postoperative efficacy,in order to reduce unnecessary damage to patients'health by standardizing the scope of clinical applications.Finally,the whole process of FMT clinical operation is summarized,and corresponding clinical application suggestions are given.We expect to provide clinicians with a reference for FMT surgical specifications.We expect to provide clinicians with reference to FMT operating standards.
作者
王玉莹
石汉平
饶本强
Wang Yuying;Shi Hanping;Rao Benqiang(Department of Gastrointestinal Surgery/Clinical Nutrition,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Key Laboratory of Cancer FSMP for State Market Regulation,Beijing 100038,China)
出处
《肿瘤代谢与营养电子杂志》
2022年第3期390-395,共6页
Electronic Journal of Metabolism and Nutrition of Cancer
基金
北京市自然科学基金(7202076)。
关键词
粪菌移植
操作流程
临床应用
建议
Fecal microbiota transplantation
Operating procedures
Clinical application
Recommendation
