不同时机空肠内营养对犬急性胰腺炎治疗效果的研究

发布时间：2018-06-10 00:41

  本文选题：肠内营养 + 急性胰腺炎　； 参考：《畜牧与兽医》2017年05期

【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(P0.05)。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(P0.05);EN-1在第4天与TPN组、EN-2组、EN-3组比较有显著性差异(P0.05),EN-2组在第6天与TPN组、EN-3组比较有显著性差异(P0.05),EN-3在第8 d与TPN组比较有统计学差异(P0.05)。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。
[Abstract]:To study the treatment time of jejunal nutrition therapy for acute pancreatitis in dogs. A canine model of acute pancreatitis was induced by retrograde injection of 5% sodium taurocholate trypsin into the main pancreatic duct at a pressure of 1 mL / kg. Dogs with acute pancreatitis were randomly divided into two groups: EN-1 / 72 h enteral nutrition group (EN-3) and sham operation group (6 dogs). After induction, jejunal nutrition was performed in en group at 24 d 72 120 h, and the treatment period was 7 d. D-lactic acid (D-lactic acid), plasma endotoxin (endotoxin), white blood cell (WBC), neutrophils (neutrophils) and C-reactive protein (C- reactive protein) were observed for 8 days. The histopathological changes were observed by HE staining on the 8th day of the experiment and the jejunum and ileum tissues were stained by HE staining to observe the morphology of intestinal mucosa. Results: the amylase content in en group was significantly higher than that in S group after model making. After 8 days, the amylase content in en group was lower than that in TPN group, but there was no significant difference in amylase content between en group and TPN group (P 0.05). In D-lactic acid, plasma endotoxin C-reactive protein, There was a significant difference in white blood cell between EN-3 group and TPN group on the 4th day. There was a significant difference between P0.05EN-3 group and TPN group on the 6th day compared with TPN group EN-3 group on the 8th day (P 0.05). Histopathology showed that the intestinal mucosal injury in en group was lighter than that in TPN group. The earlier enteral nutrition started in en group, the more neat villi were and the thicker the intestinal mucosa was. The results showed that early enteral nutrition was safe and effective in the treatment of canine AP by starting enteral nutrition within 120 hours.
【作者单位】： 南京农业大学动物医学院;
【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)
【分类号】：S858.292
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本文编号：2001381