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1、CasepresentationA44-year-oldwoman，proximalgastrectomyandbilateraltruncalvagotomyforagastricneuroendocrinetumorthethirddaybloating,nauseaandvomitingthefourthday,waterydiarrhea.BP60/38mmHgLac8.2mmol/LtransferredtoICUthefifthday,39.6℃,ARDS,intubation,diarrheawasagg
2、ravated,greenish,wateryliquidexceeding1,800ml.septicshock,Sulbactam,ornidazole,NE.->VV-ECMO+CRRTConditiongraduallystabilized.VV-ECMOandCRRTwerestoppedonthe12thday,butdiarrheadidnotshownanyimprovement.Bloodcultures:AcinetobacterbaumanniiandEnterococcusfaecalis->I
3、mipenem,caspofungin,penicillinand/orlinezolid.Antibioticswerecontinueduntil28days,stillhadafever(38.3℃)waterystoolsreached2,855ml.bloodculture:Propionibacteriumacnes(瘡皰丙酸桿菌)CRP103.3mg/LCasepresentationCasepresentationCasepresentation健康人患者Fecalmicrobiotatransplan
4、tationCriticalCare(2015)19:37CriticalCare(2015)19:37CriticalCare(2015)19:37CriticalCare(2015)19:37ImmunomodulatoryeffectCriticalCare(2015)19:37Thisreportprovidesa?wonderfulexampleofaproof-of-conceptstudyindicatingthatFMTmayrepresentanidealtherapeuticalternative?
5、tocontrolsystemicinflammationinpatientswithsepsis.CriticalCare(2015)19:37FecalMicrobiotaTransplantation糞菌移植過去野葛芋毒、山中毒菌欲死者，并飲糞汁一升，即活。明朝李時(shí)珍所著《本草綱目》，記載用人糞治病的療方多達(dá)二十多種，也強(qiáng)調(diào)了發(fā)酵糞便上清液和新鮮糞清?，F(xiàn)代的發(fā)展1958年，美國(guó)Eiseman首次報(bào)道FMT用于治療人偽膜性腸炎。1983年，瑞典Schwan首次報(bào)道通過灌腸FMT治療CDI獲得很好療效1989年，Be
6、nnet和Brinkman首次報(bào)道FMT治療UC取得了很好的療效2013年，NEJM發(fā)文示FMT治療復(fù)發(fā)性CDI的臨床對(duì)照研究證明FMT的療效顯著優(yōu)于萬古霉素?！禨cience》和《TIME》將其評(píng)為2013年生物醫(yī)學(xué)的十大突破之一。Gastroenterology,2013,145(5):946-953目前的應(yīng)用小兒自閉癥Gastroenterology,2013,145(5):946-953Freshstoolsamplesfromhealthydonorsweretransportedtotheprocessin
7、glaboratorieswithin5hoursofcollectionandstoredat5°CuntilfrozenorusedforFMT.Frozensuspensionswerekeptat?20°Cforamaximumof30daysandthawedovernightat25℃.CONCLUSIONS：AmongadultswithrecurrentorrefractoryCDI,theuseoffrozencomparedwithfreshFMTdidnotresultinworseproport
8、ionofclinicalresolutionofdiarrhea.GiventhepotentialadvantagesofprovidingfrozenFMT,itsuseisareasonableoptioninthissetting.JAMA.2016;315(2):142-149.不良事件Gastroenterology
