严重创伤早期肠道营养对肠粘膜结构及功能的作用

Effects of Early Enteral Feeding on the Bowel barrier function Following Severe Burn Injury

为研究严重创伤肠道屏障功能的改变及早期肠道营养对肠道的保护，笔者设计一小型猪实验模型，分别在门静脉、肠系膜下静脉及中心静脉插入导管，使对肠道进行客观和动态的研究成为可能。术后７天将动物造成３０％Ⅲ度烧伤，随机分为早期喂养（ＥＦ）组，伤后２小时开始喂养；延迟喂养（ＤＦ）组，伤后４天开始喂养。结果表明，ＥＦ组动物肠粘膜结构和功能较ＤＦ组明显改善。笔者认为，早期肠道营养通过及时有效地改善肠粘膜缺血缺氧状态、对肠粘膜的营养支持和恢复并维持肠道内微生态环境稳定等方面的作用，达到增强肠粘膜屏障功能、减少肠源性感染发生的目的。

In order to study the changes of the bowel barrier function and its preservation, a new animal model, a specially bred miniswine (Gui Zhou Species) was developed in this study, to which multiple catheterizations were applied for sampling different blood from portal, inferior mesenteric as will as jugular (central) veins. The animals were sustained with 30% III° burn of TBSA 7 days affer the catheterization and divided randomly into early feeding (EF) group, given a complete diet beginning from 2 hours postburn (N=6), and delayed feeding (DF) group, given the same diet initiating on PBD4(N=6). The results indicated that the bowel barrier function was weakened significantly early postburn so that the translocation of both endotoxin and bacteria from the gut to portal vein was evidently increased. However, by improving the intestinal mucosa ischemia, preserving mucosal mass and maintaining bowel microecological balance through early enteral feeding, as revealed in this study; the barrier function could be enhanced and the translocation of bacteria and endotoxin would be thus decreased in some extent. (Original article on page 361)