Abstract: ［Abstract］ Objective To investigate the effect of enhanced recovery after surgery combined with probiotics on intestinal microflora in patients with colorectal cancer after operation. Methods From May 2016 to May 2018， 126 patients with colorectal cancer were prospectively enrolled in the gastrointestinal surgery department of Jiangmen Central Hospital. According to the random number table method， the patients were divided into control group （59 cases， ERAS group） and experimental group （67 cases， ERAS combined with probiotics treatment group）. The changes of intestinal floras in different genus and the grading of intestinal floras disorder were compared between the two groups. The incidence of complications related to intestinal infection was compared between the two groups. Results Dysbacteriosis were happened before operation in both groups （P>0.05）. The majority of patients in the control group were Ⅱ° dysbacteriosis after operation， while those in the experimental group were mainly I°dysbacteriosis after operation （P=0.014）. The total number of bifidobacteria and lactobacillus in the experimental group was higher than that in the control group （P<0.001）. The incidence of diarrhea， abdominal infection and anastomotic leakage in the control group was higher than that in the experimental group， but only the incidence of diarrhea had significant difference between the two groups， while the incidence of abdominal infection and anastomotic leakage had no significant difference. There was no sepsis after operation in both groups. Conclusions Perioperative probiotic therapy for colorectal cancer patients can improve the intestinal microecological environment， protect the intestinal mucosal barrier and accelerate the recovery of patients.

Key words: probiotics, colorectal cancer, intestinal floras, enhanced recovery after surgery

摘要： ［摘要］ 目的 探讨加速康复外科联合益生菌对结直肠癌患者术后肠道菌群变化的影响。方法 前瞻性纳入2016年5月至2018年5月江门市中心医院胃肠外科收治的结直肠癌患者126例，将入组患者分为对照组（59例，单纯ERAS组）和实验组（67例，ERAS联合益生菌治疗组）。比较两组患者术后肠道菌群不同菌属数量的变化及菌群紊乱的分度，比较两组患者术后肠源性感染相关并发症的发生率。结果 两组患者术前均出现不同程度的菌群失调（P>0.05），对照组患者术后以Ⅱ°菌群失调居多，而实验组患者术后主要表现为Ⅰ°的菌群失调（P=0.014）。术后实验组双歧杆菌、乳酸杆菌计数总量均高于对照组（P<0.001）。对照组术后出现腹泻、腹腔感染、吻合口漏的发生率比实验组高，但只有腹泻的发生率两组差异有统计学意义，腹腔感染和吻合口漏统计学差异不明显。两组患者术后均无出现脓毒血症。结论 结直肠癌患者围手术期予以益生菌治疗，可改善肠道微生态环境，保护肠道黏膜屏障，加速患者术后康复。

关键词: 结直肠癌, 益生菌, 肠道菌群, 加速康复外科