严重烧伤早期肠粘膜屏障功能改变及肠道营养的实验研究

Prcscrving intestinal function after severe burn injury

为进一步探讨严重烧伤早期肠粘膜屏障功能的改变及肠道营养的作用，作者设计了一个新的动物模型，即在肠系膜下静脉、门静脉和中心静脉插入导管分别获取不同区域的血标本进行细菌培养和测定内毒素等指标，使研究成为一个既相对独立义相互关联的整体。避免了既往模型的向肠道灌饲活菌使肠粘膜遭受非创伤原因损害的人为影响因素。致伤（体表烧伤ＩＩＩ°达３０％、）后动物随机分为两组：早期饲养（ＥＦ）组（伤后２小时开始饲养）和延迟饲养（ＤＦ）组（伤后第４天开始饲养）。结果表明，早期肠道营养能明显刺激伤后肠粘膜细胞的增殖与修复，能有效地增强肠粘膜屏障功能，明显减少肠道细菌及内毒素的移位。肠道内的食物对于维护肠粘膜的结构和功能以及修复受损的肠粘膜细胞是至关重要的。

o study the changes of the bowel-barrier func-tion and its preservation. we developed a new animalmodel. A specially bred miniswine Guizhou species)was used with multiple catheterizations for samplingdifferent blood from portal, inferior niesentene as willas jugulat (central) veins. The animals were sustaineduith 30% III burns of TBSA 7 days aftercatheieriztition and divided randomly into early feed-ing (EF) group. given a complete diet beginning from2 hours posthum (n=6) and delayed feeding (DF)group. given the same diet initiating on 4 daysposthurn (n=6). The results indicated that thebowel-barrier function was weakened significantlyearly posthurn so that the translocation of bothendotoxin and bacteria from the gut to portal vein wasevidently increased. However, improving the intestinalmucosa ischemia. preserving mucosal mass and main-taining bowel-microecological balance through ear-ly enteral feeding, as revealed in this study- could en-hance the barrier function. and the translocation ofbacteria and endotoxin would be thus decreased tosome extent.