Pfeiffer A, Schmidt T, Kaess H
Department of Gastroenterology and Hepatology, Städtisches Krankenhaus München-Bogenhausen, Akademisches Lehrkrankenhaus, Munich, Germany.
Aliment Pharmacol Ther. 1998 Mar;12(3):281-6. doi: 10.1046/j.1365-2036.1998.00301.x.
Loss of water during enteral nutrition following massive intestinal resection may be severe. Low osmolality of oral rehydration solutions has recently been shown to mediate an increase in water absorption.
To evaluate the effect of osmolality of a nutrient solution on the intraluminal duodenojejunal water flow, and the net absorption rates of total nitrogen and carbohydrate.
Eight healthy volunteers with a mean age of 27 (range 25-29) years participated in the study. Enteral nutrition (17% protein, 59% carbohydrate, 24% lipid plus 5 g/L PEG 4000) was infused (5 mL/min 2.64 kcal/min) into the descending duodenum either as a hypotonic (160 mOsmol/kg) or as an isotonic solution in a random order. Intestinal samples were aspirated 20 and 45 cm distally to the infusion point.
Intraluminal water flow rates were significantly lower with the hypotonic solution than with the isotonic solution, both in the duodenum (4.9 +/- 0.3 vs. 6.7 +/- 0.5 mL/min; P < 0.02) and the upper jejunum (3.0 +/- 0.1 vs. 3.9 +/- 0.2 mL/min; P < 0.005). The net absorption rates of total nitrogen and carbohydrate were similar with both solutions.
Low osmolality of a nutrient solution decreases intraluminal water flow rates in the upper intestine without affecting the absorption rates of total nitrogen and carbohydrate. Compared with an isotonic solution, the use of a hypotonic solution might lower the water loss in patients with extensive short bowel intestinal resection.
大规模肠道切除术后肠内营养期间的水分流失可能很严重。最近研究表明，口服补液溶液的低渗透压可促进水分吸收增加。
评估营养液渗透压对十二指肠空肠腔内水流以及总氮和碳水化合物净吸收率的影响。
8名平均年龄27岁（范围25 - 29岁）的健康志愿者参与了该研究。肠内营养（17%蛋白质、59%碳水化合物、24%脂质加5 g/L聚乙二醇4000）以5 mL/分钟（2.64千卡/分钟）的速度随机以低渗（160毫摩尔/千克）或等渗溶液的形式输注到十二指肠降部。在输注点远端20厘米和45厘米处抽取肠样本。
低渗溶液组的腔内水流速度显著低于等渗溶液组，在十二指肠（4.9±0.3对6.7±0.5 mL/分钟；P < 0.02）和空肠上段（3.0±0.1对3.9±0.2 mL/分钟；P < 0.005）均如此。两种溶液的总氮和碳水化合物净吸收率相似。
营养液的低渗透压可降低上肠道的腔内水流速度，而不影响总氮和碳水化合物的吸收率。与等渗溶液相比，使用低渗溶液可能会降低广泛小肠切除患者的水分流失。
