腹主动脉瘤择期手术后的内毒素血症及早期经口进食的影响
Endotoxemia after elective surgery for abdominal aortic aneurysm and the effect of early oral feeding.
作者信息
Sugita T, Watarida S, Katsuyama K, Nakajima Y, Yamamoto R, Matsuno S, Tabata R, Mori A
机构信息
Second Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Japan.
出版信息
J Cardiovasc Surg (Torino). 1998 Oct;39(5):547-9.
BACKGROUND
Endotoxemia after major vascular surgery has been suggested to be caused by the passage of bacterial endotoxins through the gut. Early enteral feeding has been reported to prevent bacterial translocation. Therefore, we investigated the incidence of endotoxemia in 12 patients with normal liver function after elective surgery for abdominal aortic aneurysm.
METHODS
Blood samples were taken from the brachial vein of each patient before surgery, 1 day after surgery, and 3 days after surgery. The endotoxin concentration was measured using a chromogenic endotoxin-specific assay.
RESULTS
The endotoxin concentration was significantly higher one day after surgery (2.15+/-1.36 pg/ml) than that before surgery (1.27+/-1.00 pg/mL), (p<0.05). The mean endotoxin concentration in the patients after early oral feeding (0.74+/-0.74 pg/ml) was significantly lower than that in the patients who could not eat (1.58+/-0.48 pg/ml).
CONCLUSIONS
A low concentration of systemic endotoxins can be observed after surgery for abdominal aortic aneurysm, and early oral feeding prevented this elevation.
背景
大血管手术后的内毒素血症被认为是由细菌内毒素通过肠道进入血液循环引起的。据报道，早期肠内喂养可预防细菌移位。因此，我们调查了12例肝功能正常的患者在择期腹主动脉瘤手术后内毒素血症的发生率。
方法
在手术前、手术后1天和手术后3天从每位患者的肱静脉采集血样。使用显色内毒素特异性测定法测量内毒素浓度。
结果
手术后1天的内毒素浓度（2.15±1.36 pg/ml）显著高于手术前（1.27±1.00 pg/mL），（p<0.05）。早期口服喂养患者的平均内毒素浓度（0.74±0.74 pg/ml）显著低于不能进食患者（1.58±0.48 pg/ml）。
结论
腹主动脉瘤手术后可观察到全身内毒素浓度较低，早期口服喂养可防止这种升高。
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