肠内免疫营养预防大鼠术后腹腔粘连的实验研究  

Experimental study of enteral immunonutrition on the prevention of postoperative peritoneal adhesion in rat

作　　者：白化天[1] 陈静[2] 杨秀峰[1] 杨哲[1] 折占飞[1] 王二明[1] 郭东海[1] 付伟[1] 

机构地区：[1]内蒙古自治区鄂尔多斯市中心医院普外科,内蒙古东胜017000 [2]内蒙古自治区鄂尔多斯市中心医院麻醉科,内蒙古东胜017000

出　　处：《中国医师杂志》2007年第12期1640-1642,共3页Journal of Chinese Physician

摘　　要：目的探讨肠内免疫营养对大鼠术后腹腔炎症反应及腹腔粘连程度的影响。方法32只雄性SD大鼠随机分为肠内免疫营养（EIN）组和肠内营养（EN）组。喂食5d后行腹壁和盲肠浆膜的缺损术制成大鼠腹腔粘连模型。分别于术后1、4、7、10d取腹腔灌洗液测定IL-6、TNF-α含量；术后10d处死动物，观察腹腔粘连状况并送病理检查。结果术后EIN组和EN组腹腔灌洗液IL-6和TNF-α的水平较对照组显著升高（P〈0.01）。EIN组腹腔灌洗液IL-6和TNF-α水平在术后4、7、10d较EN组明显降低（P〈0.05）。EIN组和EN组粘连分级差异有统计学意义（P〈0.01）。光镜下EIN组炎症反应轻微，纤维增生不明显。结论EIN可以减轻大鼠术后腹腔炎症反应，并能有效地降低腹腔粘连的发生。Objectives To study the influence of enteral immunonutrition on the postoperative peritoneal inflammatory reaction and adhesive degree in rat. Methods Thirty-two SD male rats were random divided into enteral immunonutrition （EIN） and enteral nutrition （EN） groups, The adhesive model was developed by making defects on the peritoneal wall and cecal surface after feeding five day, The peritoneal lavage fluid of the adhesive model rats were obtained on the first, fourth, seventh and tenth day after operation, All samples were processed and the levels of IL-6 and TNF-α were determined. The adhesive degree was observed and biopsy was taken on the tenth postoperative day, Results After operation, the levels of IL-6 and TNF-α of peritoneal lavage fluid in the model groups were higher than that in the normal control group（ P 〈0.01 ）, The levels of IL-6 and TNF-α of peritoneal lavage fluid in EIN group were significantly lower than that in EN group on the fourth, seventh and tenth day after operation （ P 〈 0. 05 ）, There was significantly different adhesion degree between EIN group and EN group, Mild inflammatory changes and less fibrous proliferation were observed in EIN group under microscope, Conclusions Enteral immunonutrition may effectively reduce postoperative peritoneal inflammatory reaction and adhesion in rat.

关 键 词：肠道营养/方法 手术后并发症/预防和控制 粘连/预防和控制 

分 类 号：R656[医药卫生—外科学] R45[医药卫生—临床医学]