摘要
目的测定腹部创伤患者术后甘露醇 (mannitol,M)和乳果糖 (lactulose ,L)吸收的浓度变化 ,观察肠内营养 (EN)、胃肠外营养 (PN)对肠道通透性及全身炎性反应影响。方法 30例患者随机分为PN和EN组 ,每组 15例 ,计算手术第 1、3、5、7天L M和APACHEⅡ评分。结果PN组L M第5天最高 (0 0 6 1± 0 0 0 2 ) ,与手术第 1天比较 ,差异有显著意义 (P <0 0 5 ) ,APACHEⅡ评分在第 3天最高 ,为 (17 6± 1 8)分 ,较手术第 1天差异有显著意义 (t=2 316 ,P <0 0 5 ) ,L M与APACHEⅡ评分正相关 (r=0 745 ,t=2 2 35 ,P <0 0 5 )。EN组L M第 3天 (0 0 47± 0 0 0 4) ,较手术第 1天差异有显著意义(t=2 35 2 ,P <0 0 5 ) ,APACHEⅡ评分第 3天最高 ,为 (15 9± 2 3)分 ,较术后第 1天差异有显著意义(t=2 35 2 ,P <0 0 5 ) ,L M比值与APACHEⅡ评分正相关 (r =0 730 ,t=2 375 ,P <0 0 5 )。结论与PN相比 ,EN能改善肠道粘膜通透性 。
Objective To study the effects of respective early enteral (EN) and parenteral nutrition (PN) surpport on intestinal permeability and systemic inflammatory response in patients with abdominal trauma.Methods Thirty abdomen trauma patients were divided into 2 groups:1. EN group (n=15),2. PN group(n=15).The L/M (lactulose over mannitol) permeability was determined on the day of operation and 3,5,7 days post-op. The APACHE Ⅱ scores were evaluated.Results In PN group,the L/M ratio reached the highest point on 5th day (0.061±0.002,P<0.05).A significant correlation between the APACHE Ⅱand the L/M ratio was observed(r=0.745,t=2.235,P<0.05).In EN group, the L/M ratio reached the highest point on 3rd day( 0.047±0.004,P<0.05).A significant correlation between the APACHE Ⅱand the L/M ratio was observed( r=0.730,t=2.375,P<0.05).Conclusion In the abdomen trauma patients,the early enteral nutrition support significantly alleviates systematic inflammatory response.
出处
《中华普通外科杂志》
CSCD
北大核心
2002年第3期160-162,共3页
Chinese Journal of General Surgery
