老年股骨近端防旋髓内钉术后谵妄患者肠道菌群的变化研究OA

Objective To investigate the changes of intestinal flora in elderly patients with postoperative delirium(POD)following proximal femoral nail antirotation(PFNA)surgery.Methods A total of 89 elderly patients who underwent unilateral PFNA surgery were enrolled as research subjects,and divided into the POD group(31 cases)and the non-POD group(58 cases)according to the occurrence of POD after surgery.The shannon index,chao1 index,relative abundances of intestinal flora at phylum and genus levels,and the incidence of gastrointestinal adverse reactions were compared between the two groups before and after surgery.Results After surgery,the shannon index and chao1 index of patients in the POD group were significantly lower than those in the non-POD group(P<0.05).The relative abundances of actinobacteriota and bacteroidota in the POD group were significantly lower than those in the non-POD group(P<0.05),while the relative abundances of firmicutes and proteobacteria were significantly higher than those in the non-POD group(P<0.05).At the genus level,the relative abundances of sutterella,staphylococcus,proteus and clostridium in the POD group were significantly higher than those in the non-POD group(P<0.05),whereas the relative abundances of bifidobacterium,faecalibacterium and bacteroides were significantly lower than those in the non-POD group(P<0.05).The incidence of postoperative gastrointestinal adverse reactions within 3 days after surgery in the POD group was significantly higher than that in the non-POD group(P<0.05).Conclusion POD may lead to decreased intestinal flora diversity and increased gastrointestinal adverse reactions in elderly patients with PFNA,which is generally characterized by reduced beneficial bacteria and increased opportunistic pathogens.The structural abnormalities of intestinal flora at both phylum and genus levels may also be involved in the occurrence of POD.