Study on changes of intestinal flora in elderly patients with postoperative delirium after proximal femoral nail antirotation surgery

TAO Ying; QIAO Chang-qing; YE Xia; WANG Fei; LI Yuan-sen

doi:10.11659/jjssx.08E025043

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Study on changes of intestinal flora in elderly patients with postoperative delirium after proximal femoral nail antirotation surgery

Clinical Research | 更新时间：2026-03-09

- Study on changes of intestinal flora in elderly patients with postoperative delirium after proximal femoral nail antirotation surgery
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 2, Pages: 157-160(2026)
- 作者机构：
  
  南京江北医院麻醉科，江苏南京 210000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.08E025043
  CLC： R683.42
- Received：10 August 2025，
  
  Published：25 February 2026
- 稿件说明：
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陶莹,乔长青,叶霞等.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[J].局解手术学杂志,2026,35(02):157-160.

TAO Ying,QIAO Chang-qing,YE Xia,et al.Study on changes of intestinal flora in elderly patients with postoperative delirium after proximal femoral nail antirotation surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(02):157-160.
陶莹,乔长青,叶霞等.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[J].局解手术学杂志,2026,35(02):157-160. DOI： 10.11659/jjssx.08E025043.

TAO Ying,QIAO Chang-qing,YE Xia,et al.Study on changes of intestinal flora in elderly patients with postoperative delirium after proximal femoral nail antirotation surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(02):157-160. DOI： 10.11659/jjssx.08E025043.

摘要

目的

探讨老年股骨近端防旋髓内钉（PFNA）术后谵妄（POD）患者的肠道菌群变化情况。

方法

选取行单侧PFNA手术的89例老年患者为研究对象，根据术后是否发生POD分为POD组（31例）和非POD组(58例)。比较2组患者手术前后的shannon指数和chao1指数、肠道菌群门水平及属水平相对丰度、胃肠道不良反应发生情况。

结果

在手术后，POD组患者的shannon指数和chao1指数均显著低于非POD组（

0.05）；POD组患者的放线菌门及拟杆菌门相对丰度均显著低于非POD组（

0.05），厚壁菌门及变形菌门相对丰度均显著高于非POD组（

0.05）；POD组患者的萨特氏菌属、葡萄球菌属、变形杆菌属及梭状芽孢杆菌属相对丰度均显著高于非POD组（

0.05），双歧杆菌属、柔嫩梭菌属及拟杆菌属相对丰度均显著低于非POD组（

0.05）。POD组患者术后3 d内的胃肠道不良反应发生率显著高于非POD组（

0.05）。

结论

POD可能会引发老年PFNA患者肠道菌群多样性下降及胃肠道不良反应，总体表现为POD患者的有益菌减少、条件致病菌增多，肠道菌群门水平及属水平结构异常也可能参与了POD的发生。

Abstract

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 （

0.05）.The relative abundances of actinobacteriota and bacteroidota in the POD group were significantly lower than those in the non-POD group （

0.05），while the relative abundances of firmicutes and proteobacteria were significantly higher than those in the non-POD group（

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 （

0.05），whereas the relative abundances of bifidobacterium，faecalibacterium and bacteroides were significantly lower than those in the non-POD group （

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 （

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.

关键词

Keywords

references

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