To evaluate the effect of intra-abdominal pressure and the change of gastrointestinal function in patients of advanced valvular heart disease using probiotics and lactulose after operation.

From August 2013 to August 2014, fifty-six patients were selected and divided into two groups randomly: 28 cases in the treatment group, using probiotics and lactulose the first day after operation until the seventh day. The other 28 cases were the control group, undergoing the same procedure except for probiotics and lactulose. IAP was measured preoperatively, the first, second, third, fourth, and fifth day after operation in the two groups through measuring the bladder pressure. Postoperative defecation time for the first time (d), ICU stay time (h), postoperative length of hospital stay (d), incidence of IAH/ACS gastrointestinal dysfunction and mortality in the two groups were also recorded.

There was no statistically significant difference between the two groups in IAP preoperatively [(3.96±1.63) mmHg vs (3.63±1.58) mmHg, t=0.44, P=0.63] and one day after operation [(11.87±2.22) mmHg vs (11.58±2.76) mmHg, t=1.62, P=0.11]. Postoperative IAP in the two groups increased at first and then decreased, reaching up to the peak at the third day in treatment group and the fourth day in the control group. At the beginning of the second day after operation, the difference was statistically significant (2-5 day after operation, t=2.24, 2.47, 4.23, 4.92, P=0.02, 0.04, 0.00, 0.00). And differences were statistically significant between groups on postoperative defecation for the first time(t=2.36, P=0.03), ICU stay time (t=3.87, P=0.00) , postoperative length of hospital stay (t=2.76, P=0.01), incidence of IAH (14.28% vs 39.28%, χ²=4.46, P=0.04) and gastrointestinal dysfunction (7.14% vs 28.57%, χ²=4.38, P=0.04).

Use of probiotics and lactulose in advanced valvular disease after operation can effectively reduce IAP, improve gastrointestinal function, and reduce the length of ICU and postoperative hospital stay.