早期肠道营养减轻烧伤后应激的研究

Effect of early enteral nutrition on stress and organ injury in burned rats

目的 比较早期肠道营养与早期静脉营养减轻内脏应激损害的效应。方法 Wistar大鼠 6 6只分成正常对照组、早期静脉营养组 (PN)、早期肠道营养组 (EN) ,PN组、EN组制成 30 %TBSAⅢ度烧伤模型。分组灌喂或颈外静脉输液给予相同热量和热氮比的营养液。烧伤后 6、12、2 4、48、72h检测应激激素尿儿茶酚胺和血浆皮质醇及肝肾组织血管通透性、血流量、MDA、SOD的变化。结果 烧伤后大鼠皮质醇、儿茶酚胺均较对照组升高 ,EN组在多个时相点低于PN组 (P <0 .0 5～ 0 .0 1)。EN组肝肾血管通透性和MDA在多个时相点低于PN组 (P <0 .0 5～ 0 .0 1) ,EN组肝肾血流量和SOD在多个时相点高于PN组 (P <0 .0 5～ 0 .0 1)。结论 早期肠道营养可调理应激 ,减轻内脏应激损害。

Objective Compare the effect of early enteral nutrition and early parenteral nutrition on stress and organ injury after burns. Methods Wistar rats were randomly divided into early enteral nutrition (EN) group, early parenteral nutrition (PN) group and control (C) group. The EN and PN groups were inflicted with 30% TBSA full thickness skin burns, EN group were fed by Aolikang liquid intragastrically, and PN group were fed by infusion of nutrition liquid through the neck vein. Same carolies and protein were supplied to the two groups. Cortisol in plasma, content of catecholamine in urine, vascular permeability, blood flow, SOD and MDA in kidney and liver fissues were determined. Results Compared with C group, the content of cortisol in plasma and catecholamine in urine in EN and PN groups increased significantly ( P <0.05～0.01), PN group was significantly higher than that in EN group in most time points ( P <0.05～0.01). The vascular permeability of liver and kidney tissues in EN and PN groups increased significantly than in C group ( P <0.05～0.01), It was significantly higher in PN group than in EN group in most time point ( P <0.05～0.01). The blood flow of liver and kidney in EN and PN groups were lower than in C group ( P <0.05～0.01), it was higher in EN group than in PN group in most time points ( P <0.05). The level of SOD in EN and PN groups were decreased than C group ( P <0.05), EN group was higher than in PN group in most time points ( P <0.05). Compared with C group, the MDA content in liver and kidney tissue in EN and PN groups increased significantly in most time points ( P <0.05～0.01), EN group was lower than PN group in most time points ( P <0.05). Conclusion Early enteral nutrition is more effective in reducing stress, decreasing organ injury.