Correction of Violations Intestinal Microflora at Patients after Cholecystectomy

Maksimlyuk V. I.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Cholelithiasis occupies one of leading places in pathology of the biliary system. Cholecystectomy be- came the basic method of treatment of cholelithiasis and went out into second place in the world after apendectomy due to introduction into wide clinical practice of little invasion surgical technologies. Violation of high-quality and quantitative composition of intestinal microflora which develops after cholecys- tectomy is one of the not studied questions in clinical medicine. With the deletion of gall-bladder its concentration function is damaged which is accompanied with the decline of bacterial properties of bile. Next to other factors it creates terms for contamination of bowel with pathogenic microflora and development of intestinal dysbacteriosis. Examination of patients after cholecystectomy allowed to find out the expressed changes of composition of mi- croflora of large intestine, which complicated disease and prolonged the terms of treatment. The research purpose of our work was to promote efficiency of treatment of patients after cholecystectomy on the basis of correction of intestinal disbacteriosis by including to complex therapy of probiotic Lacium. There have been adduced the results of research of intestinal microflora composition in patients after chole- cystectomy and influence on it of treatment with including of probiotic Lacium is analysed. Substantial violations of quantitative and high-quality composition of microflora of intestine are marked for patients after cholecystectomy – increase of amount of pathogenic microorganisms (Klebsiella, Citrobacter, Protei, Enterobacter, Collibacillus, Staphylococcuss, fungi Candida) on a background of diminishing of content of Bifidobakterium and Laktobacillus. The changes of composition of microflora of large intestine were characterized by increase of general amount of collibacillus in 51 (85,00 %) patients, appearance of gemolitic Esherichia in 5 (8,33 %), growth of population level of collibacillus with damaged fermentative activity – in 31 (51,67 %) patients; increase of amount of pathogenic En- terobacteriaceae (Klebsiella, Citrobacter, Protei, Enterobacter, Collibacillus) in 39 (65,00 %) persons. At the same time increase of level of staphylococcuss was marked in 7 (11,67 %) and fungi Candida – in 7 (11,67 %) patients. Serious violations in a state of anaerobic microflora of large intestine is marked: for 41 (68,33 %) patients – the de- cline of amount of Bifidobakterium, in 29 (48,33 %) – Laktobacillus. At research of facultative microflora the isolated increase of amount of one is of representatives of pathogenic Enterobacteriaceae is marked in 7 (11,67 %) patients, their associations – in 41 (68,33 %) patients. In 25 (41,67 %) persons combination of pathogenic bacteria (including, staphylococcuss – in 3 cases) with the decreased level of Bifidobakterium. In other 16 (26,67 %) patients increase of pathogenic intestinal microflora amount in an association with decreased level of Laktobacillus is marked. Next to the rapid diminishing of clinical symptoms (diarrhea syndrome, meteorizm) reliable positive influ- ence of probiotic Lacium it has been shown on present violations of intestinal microbiocenosis for patients after cholecystectomy. Treatment with including of probiotic Lacium normalizes intestinal microbiocenosis in 90 % patients after chole- cystectomy. Positive effect of treatment with including of probiotic Lacium on quantitative and high-quality compo- sition of intestinal microflora allow to recommend Lacium for wide application in complex therapy of patients after cholecystectomy.

intestinal microflora, cholecystectomy, probiotic Lacium

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