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Protective effect of early enteral feeding on postburn impairment of liver function and its mechanism in rats 被引量:10
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作者 Zhu L Yang ZC +1 位作者 li a Cheng DC 《World Journal of Gastroenterology》 SCIE CAS CSCD 2000年第1期79-83,共5页
AIM To study the protective effect of earlyenteral feeding(EEF)on the postburnimpairment of liver function and its mechanism.METHODS Wistar rats with 30% of total bodysurface area(TBSA)full-thickness burn wereemployed... AIM To study the protective effect of earlyenteral feeding(EEF)on the postburnimpairment of liver function and its mechanism.METHODS Wistar rats with 30% of total bodysurface area(TBSA)full-thickness burn wereemployed.The effects of EEF on the postburnchanges of gastric intramucosal pH,endotoxinlevels in portal vein,water contents of hepatictissue,blood concentrations of tumor necrosisfactor(TNF-α),plasma activities of alanineaminotransferase(ALT)and asparateaminotransferase(AST),as well as the bloodcontents of total(TB)and direct bilirubin(DB),total protein(TP)and albumin(ALB)wereserially determined within 48h postburn.RESULTS EEF could significantly improvegastric mucosal acidosis,reduce portal veinendotoxin level and water content of hepatictissue,as well as plasma concentrations of TNF-α at all timepoints after severe burns(P【0.01);postburn elevation of the plasma activities ofALT,AST and the contents of TB,DB wereeffectively prevented,whereas the plasmaconcentrations of TP and ALB were markedlyincreased 24 h and 48 h posturn in EEF groupcompared with that of the burn without EEFgroup(P【0.01).CONCLUSION EEF has significant beneficialeffects on the improvement of hepatic function in rats after severe burn,and is probably relatedwith an increase in splanchnic blood flow,reduction of the absorption of gut-originendotoxin and the consequent release ofinflammatory mediators. 展开更多
关键词 Subject headings EARLY ENTERAL FEEDING liver postburn IMPAIRMENTS
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Reduced gastric acid production in burn shock period and its significance in the prevention and treatment of acute gastric mucosal lesions 被引量:7
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作者 Zhu L Yang ZC +1 位作者 li a Cheng DC 《World Journal of Gastroenterology》 SCIE CAS CSCD 2000年第1期84-88,共5页
AIM To investigate the changes of gastric acidproduction and its mechanism in shock period ofsevere burn in rats.METHODS A rat model with 30% TBSA full-thickness burn injury was employed and thegastric acid production... AIM To investigate the changes of gastric acidproduction and its mechanism in shock period ofsevere burn in rats.METHODS A rat model with 30% TBSA full-thickness burn injury was employed and thegastric acid production,together with gastricmucosal blood flow(GMBF)and energy charge(EC)were measured serially within 48hpostburn.RESULTS The gastric acid production in theacute shock period was markedly inhibited aftersevere burn injury.At the 3rd h postburn,thegastric juice volume,total acidity and acidoutput were already significantly decreased(P【0.01),and reached the lowest point,0.63mL/L±0.20mL/L,10.81mmol/L±2.58mmol/L and 2.23mmol/h±0.73mmol/hrespectively,at the 12th h postburn.Althoughrestored to some degree 24 h after thermalinjury,the variables above were stillstatistically lower,compared with those ofcontrol animals at the 48th h postburn.TheGMBF and EC were also significantly reducedafter severe burns,consistent with the trend ofgastric acid production changes.CONCLUSION Gastric acid production,as wellas GMBF and EC was predominantly decreased in the early postburn stage,suggesting that gastricmucosal ischemia and hypoxia with resultantdisturbance in energy metabolism,but notgastric acid proper,might be the decisive factorin the pathogenesis of AGML after thermalinjury,and that the preventive use of anti-aciddrugs during burn shock period wasunreasonable in some respects.Therefore,taking effective measures to improve gastricmucosal blood perfusion as early as possiblepostburn might be more preferable for the AGMLprevention and treatment. 展开更多
关键词 Subject headings gastric mucosal LESIONS gastric acid burn shock
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医源性结肠镜穿孔的诊治 被引量:14
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作者 王恒 李昂 +4 位作者 史晓辉 徐晓东 王汉涛 王颢 于恩达 《中华胃肠外科杂志》 CAS CSCD 北大核心 2018年第6期660-665,共6页
目的总结医源性结肠镜穿孔(ICP)的诊断及治疗选择。 方法回顾性分析海军军医大学附属长海医院肛肠外科结肠镜检查及治疗后发生穿孔的17例患者临床资料、治疗及其结果。 结果2000年1月至2013年12月间,共计施行结肠镜检查及治疗患者... 目的总结医源性结肠镜穿孔(ICP)的诊断及治疗选择。 方法回顾性分析海军军医大学附属长海医院肛肠外科结肠镜检查及治疗后发生穿孔的17例患者临床资料、治疗及其结果。 结果2000年1月至2013年12月间,共计施行结肠镜检查及治疗患者累计为127 106例,其中发生ICP有17例(占0.013%)。男性8例,女性9例。平均年龄65.2(32~85)岁。ICP发生至被临床诊断为ICP的间隔时间为当时至术后6 d。有8例为结肠镜下操作包括单纯结肠息肉摘除术、内镜下黏膜切除术(EMR)和内镜黏膜剥离术(ESD)后发生的穿孔,9例单纯结肠镜检查后发生穿孔。除1例患者为操作时发现"视野内可见黄色类似脂肪组织"而当即诊断ICP外,7例前期患者,采取腹部X线拍片检查进行诊断;9例后期患者均通过腹部CT检查确诊。穿孔部位:乙状结肠5例,盲肠和降结肠各3例,降乙交界2例,回肠、结肠脾曲、直乙交界和直肠各1例。1例因盲肠侧方生长型息肉行ESD治疗术后发生ICP者,采取禁食、胃肠减压、补液、抗感染、营养支持等保守治疗成功;1例结肠镜操作当时发现ICP者,立即给予结肠镜下钛夹夹闭并辅以抗感染等保守治疗成功;15例患者手术治疗,其中8例患者施行一期肠穿孔修补术、4例施行一期切除相关肠段并行吻合术、2例施行一期切除相关肠段并行造口术以及1例施行一期穿孔修补并行造口术。术后出现腹部切口感染4例,肺部感染1例,切口感染合并心血管事件、尿路感染各1例,均予以对症治疗后恢复。17例患者住院时间平均18.6(3~45)d。 结论ICP发生后,应尽快通过查体及影像学检查等进行诊断;对于结肠镜操作时发生的穿孔,部分可以采用钛夹夹闭的方式;穿孔修补术仍是ICP主要的治疗方式,必要时可以选择部分肠段切除吻合术及造口术等。 展开更多
关键词 结肠镜 医源性结肠镜穿孔 影像学检查 穿孔修补术
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