摘要
目的观察早期肠道喂养对严重烫伤大鼠肠淋巴液中内毒素的影响,探讨严重烫伤大鼠早期肠道喂养在保护肠粘膜屏障中的作用。方法采用大鼠肠淋巴瘘模型,随机分为烫伤早期肠道喂养组,烫伤对照组和单纯手术对照组,致伤前和伤后3,6,12,24小时收集肠淋巴液,测定内毒素清除量,光镜、电镜观察回肠粘膜病理改变。结果烫伤后内毒素清除量明显升高;光镜观察表明,回肠绒毛中央乳糜管明显扩张,肠上皮细胞坏死脱落;电镜观察表明,肠上皮细胞间囊性扩张,微绒毛坏死脱落,线粒体空化、嵴断裂,核周间隙扩张。早期肠道喂养组,肠淋巴液内毒素清除量明显低于烫伤对照组;光镜和电镜观察表明,回肠粘膜病理改变有不同程度的减轻。结论早期肠道喂养对大鼠肠粘膜屏障具有保护作用,从而降低了肠淋巴液中内毒素水平。
To evaluate the role of early enteral feeding in the decrease of intestinal lymph endotoxin level in severely burned rats. Methods Lymphatic fistula of intestine was created in rats for the study. The rats then sustained a 30% TBSA Ⅲ° burn and divided randomly into postburn early feeding ,delayed feeding and simple operation control groups. Dynamic changes in intestinal lymph endotoxin level, light and transmission electron microscopy (LM and TEM) of morphological changes in ileal mucosa were studied. Results After burns, the level of intestinal lymph endotoxin was evidently increased. By LM examination, ileal mucosal lacteals were dilated and villi were denuded. By TEM exam- ination, intercellular spaces between epithelial cells were dilated, microvilli were necrotic and denuded, mitochondria were swollen with cracked, cristae. However, the early enteral feeding could decrease the levels of intestinal lymph endotoxin, alleviate the pathological changes in ileal mucosa. Conclusion The results suggested that early enteral feeding may preserve the intestinal mucosal barrier and decrease in- testinal lymph endotoxin level in severely burned rats.
基金
国家自然科学基金
关键词
烧伤
肠淋巴循环
肠道喂养
内毒素
Burns
Intestinal lymph circulation
Enteral feeding
