探讨双歧杆菌、嗜酸乳杆菌及肠球菌三联活菌（金双歧）对大鼠肝切除术后细菌移位的影响。

55只Sprague-Dawley（SD）大鼠按随机数字表法随机分为3组：假手术（SO）组15只，肝大部分切除（PH）组和肝大部分切除加金双歧（PHG）组各20只。SO组大鼠仅剪断肝周韧带后关腹，PH组与PHG组大鼠行肝切除术，切除肝左内叶、左外叶和肝中叶，切除量约为肝脏总体积的2/3；SO组及PH组术后自由饮用无菌蒸馏水，PHG组行肝切除术后自由饮用金双歧溶液（含量约10⁹ CFU/ml）。术后饲养48 h后进行大鼠粪便涂片镜检并计算球菌与杆菌比例（球杆比），摘取大鼠肠系膜淋巴结进行细菌培养并计算细菌培养阳性率，抽取静脉血测定血浆内毒素水平。3组粪便球杆比（几何均数）、血浆内毒素比较采用单因素方差分析或Kruskal-Wallis非参数检验，两两比较采用LSD-t检验或Mann-Whitney检验；肠系膜淋巴结细菌培养阳性率比较采用Fisher确切概率法。

SO组大鼠粪便球杆菌比几何均数为1∶9，PH组为3∶1，PHG组为1∶4，PH组与SO组比较差异有统计学意义（LSD-t=3.34，P<0.05），PHG组与PH组比较差异有统计学意义（LSD-t=2.43，P<0.05）。SO组大鼠肠系膜淋巴结细菌阳性率7%（1/15），PH组65%（13/20），PHG组为20%（4/20），PH组大鼠肠系膜淋巴结细菌阳性率明显高于SO组（P=0.01），PHG组明显低于PH组（P=0.01）。SO组、PH组、PHG组血浆内毒素分别为中位数0（0~4.9）ng/L、4.1（1.7~94.5）ng/L、2.1（0~10.0）ng/L，PH组内毒素水平明显高于SO组和PHG组，比较差异均具有统计学意义（U=25.5，107.5；P<0.05）。

金双歧能改善大鼠肝切除术后肠道菌群失调，减少细菌移位的发生率，降低内毒素水平；术后应用金双歧可预防大鼠肝切除术后感染。

To investigate the effects of triple live combined bifidobacterium, lactobacillus and enterococcus (Golden bifid) on bacterial translocation in rats undergoing hepatectomy.

Fifty-five Sprague-Dawley (SD) rats were divided into three groups: sham operation group (SO group, n=15), partial hepatectomy group (PH group, n=20) and partial hepatectomy plus Golden bifid group (PHG group, n=20). The peri-hepatic ligaments of rats in SO group were cut off and then abdomen were closed. The left medial, lateral lobes and middle lobes of rats in the PH and PHG group were resected, which were about two-thirds of the total volume of liver. The rats in the SO group and PH group were given sterile distilled water to drink freely, while the rats in the PHG group were given Golden bifid solution (10⁹ CFU/ml) after the operation. The stool samples of rats were microscopic examined and the ratio of enterococci and entericbacilli were calculated 48 hours' feeding after the operation. The mesenteric lymph nodes were taken to culture the bacterium was cultured and the positive rate was calculated. The venous plasma endotoxin level was tested. The ratio of enterococci and entericbacilli (geometrical mean) and plasma endotoxin level among 3 groups were compared using one-way analysis of variance(ANOVA) or Kruskal-Wallis non-parametric test. LSD-t test or Mann-Whitney test was used for pairwise comparison. Fisher definite probability method was used to compare the positive rate of bacterial culture of the mesenteric lymph nodes.

Geometric means of the ratio of enterococci and entericbacilli was 1∶9 in the SO group, 3∶1 in PH group and 1∶4 in the PHG group. There was significant difference between the PH group and the SO group (LSD-t=3.34, P<0.05), and significant difference was also observed between the PHG group and the PH group (LSD-t=2.43, P<0.05) . The positive rate of bacterium cultured from the mesenteric lymph nodes was evidently higher in the PH group (7%, 1/15) than that in the SO group (65 %, 13/20; P=0.01), and that in the PHG group (20%, 4/20) was evidently lower than that in the PH group (P=0.01). The plasma endotoxin level in the SO, PH, PHG group were 0 (0-4.9) ng/L、4.1 (1.7-94.5) ng/L, 2.1 (0-10.0) ng/L respectively. The endotoxin level in the PH group was significantly higher compared with the SO and PHG group (U=25.5, 107.5; P<0.05).

Golden bifid can improve the intestinal dysbacteriosis, reduce the incidence of bacterial translocation and plasma endotoxin level of rats. Golden bifid can be applied to prevent the postoperative infection of rats after liver resection.