摘要
旨在研究空肠内营养疗法对犬急性胰腺炎的治疗时机。采用主胰管内保持一定压力逆行注入5%牛磺胆酸钠胰蛋白酶混合液(1 m L/kg)诱导犬急性胰腺炎模型。急性胰腺炎犬随机分为肠外营养组(TPN)、24 h肠内营养组(EN-1)、72 h肠内营养组(EN-2)、120 h肠内营养组(EN-3)和假手术组(S),每组6只犬。诱导后,EN组分别在24、72、120 h实施空肠营养,治疗期为7 d。造模后第2、4、6、8天观察胰淀粉酶、D-乳酸、血浆内毒素、白细胞(WBC)、中性粒细胞、C-反应蛋白等指标确定合适的营养时机。试验第8天取各组犬胰腺组织行HE染色观察其组织病理学改变;取空肠、回肠组织作HE染色,观察肠黏膜形态。结果:造模后,TPN组、EN组淀粉酶含量明显高于S组,第8天后EN组相比TPN组淀粉酶含量虽有降低,但无统计学差异(P>0.05)。在D-乳酸、血浆内毒素、C-反应蛋白、白细胞方面,S组各时间点均低于EN组、TPN组(P<0.05);EN-1在第4天与TPN组、EN-2组、EN-3组比较有显著性差异(P<0.05),EN-2组在第6天与TPN组、EN-3组比较有显著性差异(P<0.05),EN-3在第8 d与TPN组比较有统计学差异(P<0.05)。从组织病理学可以看出,EN组胰腺组织、肠黏膜损伤较TPN组轻,肠绒毛较TPN完整;EN组肠内营养启动越早,绒毛越整齐、小肠黏膜越厚。研究表明,早期肠内营养并没有加重犬AP的病情,120 h内启动肠内营养治疗犬AP安全有效。
To investigate the timing of jejunum nutrition therapy in dogs with acute pancreatitis （AP）, the AP model was induced by retro- grade injection of 5% sodium taurocholate trypsin mixture （ 1 mL/kg） with a certain pressure in the main pancreatic duct. The AP dogs were randomly divided into five groupsof 6 dogs each ： parenteral nutrition group （TPN）, 24 h enteral nutrition group （ EN- 1 ）, 72 h enteral nu- trition group （EN-2）, 120 h enteral nutrition group （EN-3） and sham operation group （S）. After induction, three EN groups were treated with jejunal nutrition at 24, 72 and 120 h for 7 days. The appropriate nutrition time was determined by the indexes of amylase, D-lactic acid, blood endotoxin, white blood cell （ WBC）, neutrophils and C-reactive protein on the 2nd, 4th, 6th and 8th day after modeling. On the 8th day, the histopathological changes and intestinal mucosal morphologywere observed by HE staining. The results showed that after model- ing, the amylase content of TPN and EN group was significantly higher than that of S group, while there was no significant difference （P〉 0. 05） in EN group compared with TPN group. In D- lactic acid, plasma endotoxin, C- reactive protein and white blood cells, S group at each time point was lower than those in EN and TPN group （P〈0. 05 ） ; EN-1 had significant difference on the 4th day, compared with TPN, EN-2 and EN-3 groups （P〈0. 05） ; EN-2 group had significant difference on the 6th day, compared with TPN and EN-3 groups （P 〈0. 05） ; EN-3 had a significant difference on the 8th day, compared with TPN group （P〈0. 05）. From the histopathology, pancreatic tis- sue and intestinal mucosal injurywas milder in EN groupthan the TPN group, and intestinal villi were intact; in EN groups, the earlier theenteral nutrition started, the more neat the villi and the thicker the intestinal mucosa kept. It suggests that the early enteral nutritiondid not aggravate the condition of canine AP, and within 120 h, the treatment of enteral nutrition against canine AP was safe and effective.
出处
《畜牧与兽医》
北大核心
2017年第5期158-165,共8页
Animal Husbandry & Veterinary Medicine
基金
江苏高校优势学科建设工程资助项目(PAPD)
国家重点研发计划(AA201600766)
关键词
肠内营养
急性胰腺炎
治疗时机
犬
enteral nutrition
acute pancreatitis
timing of treatment
dogs
