Alverdy J C, Aoys E, Moss G S
Department of Surgery, Michael Reese Hospital and Medical Center, Chicago, IL 60616.
Surgery. 1988 Aug;104(2):185-90.
Bacterial translocation from the gut may be the primary event in many disease processes. The purpose of this study was to examine the route of nutrient administration on bacterial translocation from the gut. Each of 90 female Fischer rats underwent placement of a central venous catheter and was randomized to one of three groups. Group I (control) received food and water ad libitum. Group II received standard TPN solution orally from a bottle sipper and drank the solution ad libitum. Group III underwent TPN via the central catheter by pair feeding of the animals with group II. Animals were fed for 2 weeks, and liver, spleen, mesenteric lymph nodes, blood, and cecum were aseptically obtained for culture. A statistically significant difference (p less than 0.014) was found between translocation rates of parenterally fed animals compared with enterally fed animals. Two thirds of the animals (18/27) fed parenterally had culture-positive mesenteric lymph nodes compared with one third (9/27) of the enterally fed group and none (0/30) of the control group. A statistically significant increase in the cecal bacterial count was demonstrated in the animals fed the TPN solution, independent of route. Parenteral nutrition promotes bacterial translocation from the gut by increasing the cecal bacterial count and impairing intestinal defense.
肠道细菌移位可能是许多疾病过程中的主要事件。本研究的目的是探讨营养支持途径对肠道细菌移位的影响。90只雌性Fischer大鼠均植入中心静脉导管，并随机分为三组。第一组（对照组）自由摄食和饮水。第二组通过奶瓶吸管口服标准全胃肠外营养（TPN）溶液，并自由饮用。第三组通过中心静脉导管给予TPN，动物与第二组配对饲养。动物喂养2周后，无菌获取肝脏、脾脏、肠系膜淋巴结、血液和盲肠进行培养。与经肠内喂养的动物相比，经肠外喂养的动物的细菌移位率存在统计学显著差异（p<0.014）。经肠外喂养的动物中有三分之二（18/27）肠系膜淋巴结培养呈阳性，而经肠内喂养组为三分之一（9/27），对照组无一例（0/30）呈阳性。无论途径如何，给予TPN溶液的动物盲肠细菌计数均有统计学显著增加。肠外营养通过增加盲肠细菌计数和损害肠道防御功能促进肠道细菌移位。
