Tuzlaci Ayse, Kolayli Fetiye, Muezzinoglu Bahar, Güvenç Bekir Haluk
Department of Pediatric Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye.
Department of Microbiology, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye.
J Nutr Biochem. 2025 Nov;145:110030. doi: 10.1016/j.jnutbio.2025.110030. Epub 2025 Jul 10.
Dietary restrictions, such as avoiding oral intake until postoperative ileus resolves, can result in negative nitrogen balance, weakened immune function, and impaired digestive system performance. This study investigates the efficacy of donor human breast milk (HM) in early trophic enteral feeding and its impact on gut functions during prolonged postoperative fasting in an animal model. Male Wistar rats were deprived of food for 48 hours with free water access. After a complete ileal transection and an end-to-end intestinal anastomosis, the rats were divided into three groups: prolonged fasting (PF), early trophic feeding with HM, and feeding with commercial formula (CF). Each group was further divided into 48- and 72-h postoperative subgroups. The study measured the number of colony-forming units in mesenteric lymph nodes, serum alkaline phosphatase (ALP) levels, and histopathological data between groups. At postoperative 48 and 72 hours, the mean apoptotic index of HM group was significantly lower than in PF group (P<.001). A significant decrease was observed in apoptosis in HM group over time (P=.047), while the CF (P=.327) and PF (P=.959) groups did not show significant changes. HM significantly prevented villus atrophy (P<.01), and bacterial translocation to mesenteric lymph nodes (P<.05) compared to CF and PF. Serum ALP levels, an indicator of intestinal mucosal regeneration, was significantly highest in the HM group at 72 hours compared to other groups (P=.03). These findings suggest that HM not only maintains the structural and functional gut integrity but also promotes earlier and more effective recovery of the intestinal health.
饮食限制，如在术后肠梗阻缓解前避免经口摄入，可导致负氮平衡、免疫功能减弱和消化系统性能受损。本研究在动物模型中调查了供体人乳（HM）在早期营养性肠内喂养中的疗效及其对长时间术后禁食期间肠道功能的影响。雄性Wistar大鼠禁食48小时，可自由饮水。在进行完全性回肠横断和端端肠吻合术后，将大鼠分为三组：长时间禁食（PF）组、早期用HM进行营养性喂养组和用商业配方奶（CF）喂养组。每组再进一步分为术后48小时和72小时的亚组。该研究测量了各组肠系膜淋巴结中的菌落形成单位数量、血清碱性磷酸酶（ALP）水平和组织病理学数据。在术后48小时和72小时，HM组的平均凋亡指数显著低于PF组（P<0.001）。随着时间的推移，HM组的凋亡显著减少（P=0.047），而CF组（P=0.327）和PF组（P=0.959）没有显著变化。与CF组和PF组相比，HM显著预防了绒毛萎缩（P<0.01）和细菌易位至肠系膜淋巴结（P<0.05）。血清ALP水平是肠黏膜再生的指标，与其他组相比，HM组在72小时时血清ALP水平显著最高（P=0.03）。这些发现表明，HM不仅能维持肠道结构和功能的完整性，还能促进肠道健康更早、更有效的恢复。
