Effect analysis of 71 cases of refractory diarrhea with severe malnutrition treated by fecal microbiota transplantation(FMT) combined with enteral nutrition / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To investigate the therapeutic effect of fecal microbiota transplantation(FMT) combined with enteral nutrition on patients with refractory diarrhea and severe malnutrition.METHODS: Seventy-one patients with refractory diarrhea complicated with severe malnutrition in Department of Colorectal Disease,the Tenth People ' s Hospital of Tongji University and Department of General Surgery,General Hospital of Eastern Theater Command from June 2014 to October 2018 were prospectively collected for basic information,symptoms and signs,number of bowel movements,Bristol stool scores,and nutritional indicators,which were followed up after bacterial transplantation combined with enteral nutrition.RESULTS: After following up for 6 month,FMT combined with enteral nutrition in the treatment of severe diarrhea with severe malnutrition,the effective rate of treatment of diarrhea was 95.8%,of which the cure rate was 74.7%,and the remission rate was 21.1%.3 cases(4.2%) were ineffective,6 cases(8.5%) recurred.The frequency of bowel movements decreased from(8.3±2.2) before treatment to(5.3±1.3) after 1 month,(3.2±0.8)after 3 months,and(1.9±0.6) after 6 months.The Bristol score was reduced from(6.6±0.3) points before treatment to(4.8±0.7) points 1 month after treatment,(4.6±0.8)points after 3 months,and(4.3±0.8) points after 6 months.The body mass index(BMI) of the patients before treatment was 15.3±1.3,the BMI increased to 17.4±2.4 after 1 month of treatment,increased to 19.0±3.2 after 3 months,and 19.3±3.8 after 6 months.The total protein was increased from(48.6±4.7)g/L before treatment to(55.4±5.7)g/L after1 month of treatment,increased to(60.3±5.4) g/L after 3 months,and(68.4±6.9)g after 6 months.Albumin increased from(22.4±1.7)g/L before treatment to(31.7±2.4)g/L after 1 month of treatment,increased to(35.8±2.7)g/L after 3 months,and(37.5±3.7)g/L after 6 months.Fibrinogen increased from(1.6±0.4)g/L before treatment to(2.0±0.7)g/L after 1 month of treatment,increased to(2.4±0.8) g/L after 3 months,and(2.4±0.7) g/L after 6 months.Prealbumin increased from(82.0±18.6)mg/L before treatment to(178.3±25.3)mg/L after 1 month of treatment,increased to(235.7±28.2) mg/L after 3 months,and(259.6±33.5) mg/L after 6 months.The were significant differences before and after treatment(All P<0.05) CONCLUSION: After 6 months of follow-up,FMT combined with enteral nutrition can effectively reduce the number of diarrhea,improve stool characteristics,and improve nutritional indicators such as BMI,total protein,albumin,fibrinogen and prealbumin.