不同肠内营养对结肠癌患者围手术期内肠粘膜屏障与肠形态的影响  

Study of Different Enteral Nutrition on Bacterial Translocation and Intestinal Morphology during the Intraoperative Period

作　　者：秦震声[1] 赵耀[1] 周宝祥[1] 徐果[1] 朱德祥[1] 

机构地区：[1]南京医科大学附属淮安医院胃肠外科,江苏淮安223300

出　　处：《现代生物医学进展》2013年第10期1914-1917,共4页Progress in Modern Biomedicine

摘　　要：目的:观察不同的肠内营养物对结肠癌围手术期肠粘膜屏障和肠粘膜形态的影响。方法:160例结肠癌患者随机分成4组,所有患者行标准的结肠癌根治术,在术前3天开始肠道准备,分别在术前和术后给第I组患者静脉营养;II组给予标准的要素营养;III组给予普通的肠内营养物混合物;IV组给予安素,所有患者行标准的结肠癌根治术,利用形态评分系统记录的各组结肠粘膜的变化(0-5),在术后通过内毒素和二胺氧化酶观察比较了各组肠粘膜屏障的变化。结果:给予安素的患者(IV组)与其他组相比,细菌移位显著降低,各组患者的内毒素水平经治疗后逐渐下降,其中II-IV组在治疗后的1,4,7天均低于I组(P<0.05),特别是第4组血浆内毒素水平明显低于其它各组(P<0.05)。组织学变化的评分显示在第IV组(安素)和第I-III组(静脉或者其它肠内营养物)之间相比具有显著差异(P=0.001),(I到IV组)得分分别为:2.35±0.72,1.92±1.07,1.75±1.03,0.92±0.95。结论:安素能够保护肠粘膜,降低细菌移位。Objective： To examine the effects of various enteral nutrients on bacterial translocation and intestinal morphology in the colon cancer patients during the intraoperative period.Methods： 160 patients were randomly divided into four groups.All patients had radical operation and got bowel preparation three days before operation.Group I were provided with intravenous nutrition;group II was given Elemental Powders;group III,general enteral nutrients;group IV,Ensure.Bacterial translocation was detected by endotoxin and diamine oxidase.Changes in the colon were scored from 0 to 5 with the morphologic scoring system.Results： Patients given ensure（group IV） showed a significant reduction in bacterial translocation as compared with other groups.The endotoxin levels were decreased in all groups after treatment,and it was lower in groups II-IV at d1,d4,d7 after treatment than in group I,especially was the lowest in group IV（P0.05）.The histologic scores of group IV were statistically different from the other three groups,and the score of group I-IV is respectively 2.35±0.72,1.92±1.07,1.75±1.03 and 0.92±0.95.Conclusion： Enteral diets supplemented with Ensure were found to reduce bacterial translocation and protect intestinal mucosa.

关 键 词：细菌移位 肠内营养 肠形态 

分 类 号：R735.35[医药卫生—肿瘤]