肠源性高代谢与早期肠道营养研究──烧伤引发肠源性高代谢  

Experimental study on enterogenous hypermetabolism in burns

作　　者：汪仕良[1] 黎鳌[1] 尤忠义[1] 邵洪[1] 余斌[1] 朱云[1] 余静波[1] 王凤君[1] 李超志[1] 王少龙[1] 唐成功[1] 赵云[1] 

机构地区：[1]第三军医大学西南医院烧伤研究所

出　　处：《普外临床》1996年第4期215-219,共5页

摘　　要：烧（创）伤后高代谢消耗是创伤应激、炎症反应的重要组成部分。创面是烧伤高代谢的主要源由，这已是公认的事实。为了研究烧伤后是否存在肠源性高代谢，作者从８０年代末起，共用豚（大）鼠６００只、兔６０只、小香猪３０头，建立四种动物模型。在动物实验基础上，又观察了２１例严重烧伤患者（ＴＢ－ＳＡ４５±１２．６％，深度烧伤２９±８．９％）。实验随机至少分为两组即早期喂养组及延迟喂养组。研究结果发现严重烧伤后门脉、肠粘膜血流量下降，肠组织可发生缺血再灌注损伤，肠道结构以及吸收、分泌、运动、屏障功能均明显受影响，肠道细菌、内毒素易位增加，枯否细胞等巨噬系统活化，分解激素、ＴＮＦ、ＰＧＥ＿２、ＩＬ－８等炎症介质增加，以致代谢率增高。因此，可以认为烧伤后存在“肠源性高代谢”。Abstract This study was to verify the existence of postburn enterogenous hypermetabolism. Animal models of rabbits, rats, pigs, and guinea pigs, and 21 severe burn patients (TBSA 45±12. 6%) were used. The results showed there were injury of intestinal structure and impairment of intestinal function, increment of bacterial and endotoxin translocation, activation of mononuclear system such as kupffer’s cell etc. , increase of mediators of systemic responses to metabolism such as catabolic hormones, TNF, PGE_2, IL-8 etc. , and raising of metabolic rate after severe burns. It is indicated there is existence of “gut derived postburn hypermetabolism”.

关 键 词：肠源性高代谢 肠道营养 烧伤 

分 类 号：R644[医药卫生—外科学] R459.3[医药卫生—临床医学]