胆囊切除术后腹泻患者肠道菌群特征分析
Characteristics of Gut Microbiota in Patients with Post-Cholecystectomy Diarrhea
DOI: 10.12677/acm.2026.1641389, PDF,   
作者: 曹伟韬*, 丁 振#：安徽医科大学第四附属医院肝胆外科，安徽 巢湖
关键词: 胆囊切除术后腹泻；肠道菌群；绝对定量；益生菌；Post-Cholecystectomy Diarrhea； Gut Microbiota； Absolute Quantification； Probiotics
摘要: 目的：探讨胆囊切除术后腹泻(PCD)患者肠道菌群的特征，为PCD临床防治提供依据。方法：纳入2025年7月至12月行腹腔镜胆囊切除术患者60例，分为PCD组(30例)和非PCD组(30例)，另设健康对照组(30例)。采用选择性培养基培养法对粪便样本中大肠杆菌、双歧杆菌、乳酸杆菌、拟杆菌进行绝对定量分析，比较三组间的菌群差异。结果：PCD组大肠杆菌log10CFU/g (7.53 ± 0.39)和拟杆菌(10.52 ± 0.55)显著高于健康对照组(7.11 ± 0.35、9.93 ± 0.41)和非PCD组(7.27 ± 0.42、10.20 ± 0.37) (P < 0.05)；PCD组乳酸杆菌(7.00 ± 0.46)和双歧杆菌(8.59 ± 0.51)显著低于健康对照组(7.43 ± 0.45、9.33 ± 0.33)和非PCD组(7.27 ± 0.45、8.98 ± 0.35) (P < 0.05)。结论：PCD患者肠道菌群呈特征性失调，表现为条件致病菌(大肠杆菌)和胆汁酸代谢菌(拟杆菌)增多，有益菌(双歧杆菌、乳酸杆菌)减少，为微生态干预提供了理论依据。
Abstract: Objective: To investigate the characteristics of gut microbiota in patients with post-cholecystectomy diarrhea (PCD) and provide evidence for clinical prevention and treatment of PCD. Methods: A total of 60 patients undergoing laparoscopic cholecystectomy from July to December 2025 were enrolled and divided into PCD group (n = 30) and non-PCD group (n = 30), with another 30 healthy volunteers as healthy control group. Fecal samples were collected, and absolute quantification of Escherichia coli, Bifidobacterium, Lactobacillus, and Bacteroides was performed using selective culture media. The differences in microbiota among the three groups were compared. Results: The abundances of E. coli (7.53 ± 0.39 log10CFU/g) and Bacteroides (10.52 ± 0.55) in PCD group were significantly higher than those in healthy control group (7.11 ± 0.35, 9.93 ± 0.41) and non-PCD group (7.27 ± 0.42, 10.20 ± 0.37) (P < 0.05). The abundances of Lactobacillus (7.00 ± 0.46) and Bifidobacterium (8.59 ± 0.51) in PCD group were significantly lower than those in healthy control group (7.43 ± 0.45, 9.33 ± 0.33) and non-PCD group (7.27 ± 0.45, 8.98 ± 0.35) (P < 0.05). Conclusion: Patients with PCD exhibit characteristic gut microbiota dysbiosis, manifested as increased opportunistic pathogens (E. coli) and bile acid-metabolizing bacteria (Bacteroides), and decreased beneficial bacteria (Bifidobacterium, Lactobacillus). This provides a theoretical basis for microecological intervention.
文章引用：曹伟韬, 丁振. 胆囊切除术后腹泻患者肠道菌群特征分析[J]. 临床医学进展, 2026, 16(4): 1540-1551. https://doi.org/10.12677/acm.2026.1641389

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