早期肠内营养对烧伤患者肠道功能保护作用的临床研究

[A clinical study of early enteral feeding to protect the gut function in burned patients].

作者信息

Wang S, Wang S, Li A

机构信息

Department of Surgery, 47th Army Hospital of People's Liberation Army, Chengdu.

出版信息

Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1997 Jul;13(4):267-71.

PMID:10452011

Abstract

In order to investigate the effects of early enteral feeding on the gut after burn, 21 cases (mean burn area 45%) were randomly divided into early feeding group (EF group) and delayed feeding group (DF group). The results showed that the levels of plasma endotoxin and MDA in EF group were much lower on PBD 4, 8, 14 than those of DF group (P < 0.05-0.01), and plasma SOD was much lower in DF group on PBD 4, 8 (P < 0.01). The contents of serum gastrin and plasma motilin were obviously increased, and TNF IL-8 much lower in EF group at most time points (P < 0.05-0.01). Therefore, it seems that the early enteral feeding can decrease the level of plasma endotoxin in blood, reduce reperfusion injury of the gut, and blunt the chain reaction of "endotoxin-inflammatory mediator-gut mucosa injury."

摘要

为探讨早期肠内营养对烧伤后肠道的影响，将21例患者（平均烧伤面积45%）随机分为早期营养组（EF组）和延迟营养组（DF组）。结果显示，在伤后第4、8、14天，EF组血浆内毒素和丙二醛水平显著低于DF组（P<0.05-0.01）；伤后第4、8天，DF组血浆超氧化物歧化酶水平显著低于EF组（P<0.01）。多数时间点，EF组血清胃泌素、血浆胃动素含量明显增高，肿瘤坏死因子、白细胞介素-8水平明显降低（P<0.05-0.01）。因此，早期肠内营养可降低血浆内毒素水平，减轻肠道再灌注损伤，阻断“内毒素-炎性介质-肠黏膜损伤”的连锁反应。