早期腸道內營養對內毒素及細胞因子的影響_《中國普外基礎與臨床雜志》

作者：

1. 華西醫科大學附屬第一醫院加強醫療科(成都610041)2. 華西醫科大學附屬第一醫院普外科;

關鍵詞：

多器官功能不全綜合征內毒素腸內營養腸內選擇性抑菌腫瘤壞死因子

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為了解早期腸道內營養和腸道選擇性抑菌對內毒素移位和細胞因子的影響及其在降低多器官功能不全綜合征(MODS)發生中的作用，在失血性休克再灌注動物模型基礎上，對早期腸內營養組(EN組，n＝12)、選擇性腸道清潔組(SDD組，n＝12)以及對照組(CON組，n＝12)兔門靜脈和體循環血中內毒素及TNFα水平進行了測定，并同時觀察了3組動物的死亡及發生MODS的情況。結果：EN組多器官衰竭發生率及死亡率明顯低于SDD組和CON組；EN組門靜脈及體循環血中內毒素和TNFα水平均較SDD組及CON組低；SDD組在術后第5天其門靜脈及體循環血中內毒素和TNFα仍處在較高水平，其MODS發生率及死亡率與CON組無明顯差異。本實驗結果提示：缺血再灌注損傷時可發生內毒素移位，引起內毒素血癥，引發MODS；腸道選擇性抑菌(SDD)對內毒素移位的抑制作用不明顯，不能有效地抑制MODS的發生及降低死亡率；早期建立腸道內營養是防止腸道內毒素移位，從而降低MODS發生的有效措施。

引用本文： 康焰,毛海香,熊先澤,羅傳興,吳言濤. 早期腸道內營養對內毒素及細胞因子的影響. 中國普外基礎與臨床雜志, 1999, 6(2): 70-72. doi: 復制

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1. Dorindky PM, Gaded JE. Multiple organ failure. Clin Chest Med, 1990; 11(4)∶581.
2. Carrier. Multiple organ failure syndrome. Arch Surg, 1986; 121(2)∶196.
3. Manson WJ, Dijkema H, Klasen HJ. Alteration of wound colonization by selective intestinal decontamination in thermally injured mice. Burns, 1990; 16(3)∶166.
4. 胡森，盛志勇，薛麗波等. 創傷后多系統器官衰竭(MSOF)動物模型的實驗研究. 中華整形燒傷外科雜志， 1992； 8(1)∶2.
5. Saba TM. RES systemic host defense after surgery and traumatic shock. Circ Shock, 1975; 2(1)∶91.
6. Tracey KJ, Fong Y, Hesse DG, et al. Anticachectin/TNF monoclonal antibodies prevent septic shock during lethal bacteremia. Nature, 1987; 330(6149)∶772.
7. Van Leeuwwen PAM, Hong RW, Rounds JD, et al. Hepatic failure and coma after liver resection is reversed by manipulation of gut contents: the role of endotoxin. Surgery, 1991; 110(2)∶169.
8. Coalson JJ, Benjamin B, Archer LT, et al. Prolonged shock in the baboon subjected to infusion of E coli endotoxin. Circ Shock, 1978; 5(4)∶423.
9. Nevola JS, Stocker BAD, Laux DC, et al. Colonization of the mouse intestine by an avirulent salmonella typhymurium strain and its lipopolysacchridedefective mutants. Infect Immun, 1985; 50(1)∶152.
10. Lehmann V, Freudenberg MA, Galanos C. Lethal toxicity of lipopolysacchride and tumor necrosis factor in normal and Dgalactosamine treated mice. J Exp Med, 1987; 165(3)∶657.
11. Stoutenbeek CP. Infection prevention in intensive care by selective decontamination of the digestive tract. J Crit Care, 1990; 5(2)∶137.
12. Deitch EA, Hempa AC, Specian RD, et al. A study of the relationships among survival, gut origin, sepsis and bacterial translocation in a model of systemic inflammation. J Trauma, 1992; 32(2)∶141.
13. Saito H, Trocki O, Alexander JW. The effect of route of nutrient administration on the nutritional state, catabolic hormone secretion and gutmucosal integrity after burn injury. JPEN, 1987; 11(1)∶1.
14. Alverdy J, Sang Chi H, Sheldon GF. The effect of parenteral nutrition on gastrointestinal immunity, the importance of enteral stimulation. Ann Surg, 1985; 202(6)∶681.

《中國普外基礎與臨床雜志》

早期腸道內營養對內毒素及細胞因子的影響

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《中國普外基礎與臨床雜志》

早期腸道內營養對內毒素及細胞因子的影響

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料