| 1 | Early enteral and parenteral nutritional support in patients with cirrhotic portal hypertension after pericardial devascularization显示文摘BACKGROUND: The abnormal metabolism caused by cir- rhosis always results in a complex problem about nutritional support, which will be more intricate while patients with portal hypertension are treated with pericardial devasculari- zation. Comparing the effects of early enteral and parente- ral nutritional support in patients with cirrhotic portal hy- pertension after pericardial devascularization, we try to rea lize the advantages and disadvantages of the two nutritional therapies and to guide our clinical practice. METHODS: After pericardial devascularization,40 patients with cirrhotic portal hypertension were divided randomly into 2 groups; enteral and parenteral nutritional support, respectively. The general nutritional condition, capability of producing protein, liver function, blood velocity of the portal vein, gut function, bowel bacterial translocation, mortality, complication rate, stay in ICU, duration of hos- pitalization and costs of treatment were determined in all the patients and compared between the 2 groups. RESULTS; Both enteral and parenteral nutritional supports could improve the general nutrition condition of the pa- tients; but patients receiving enteral nutritional support had fewer complications. Enteral nutrition was more ef- fective than parenteral nutrition in increasing the blood ve- locity of the portal vein, stimulating gut motion, preven- ting bowel bacterial translocation, shortening the stay in ICU and the duration of hospitalization, and saving costs of treatment. CONCLUSION: After pericardial devascularization, pa- tients with cirrhotic portal hypertension should be treated with enteral nutritional support as early as possible. | Ke Zhang, Weng-Bing Sun, Hui-Feng Wang, Zhi-Wei Li, Xiao-Dong Zhang, Hong-Bo Wang and Xu Ji Beijing, China Department of Hepatobiliary Surgery, The 302nd Hospital of PLA, Beijing 100039, China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，1： | 4 |
| 2 | 阻断淋巴通道对梗阻性黄疸大鼠肠道细菌易位的影响显示文摘目的 从阻断淋巴通道角度探讨实验性梗阻性黄疸肠道细菌易位作用的机理。方法结扎Wistar大鼠胆管,制作梗阻性黄疸模型,6 0只大鼠分为假手术组(A组)、梗阻性黄疸组(B组)和梗阻性黄疸+乳糜管结扎组(C组) ,每组各2 0只,于术后15d剖腹分别抽取下腔静脉血、门静脉血,检测其内毒素、肿瘤坏死因子 α(TNF α)、白细胞介素6 (IL 6 )的含量,并对肠系膜淋巴结、肺组织行细菌培养,对末端小肠及肺组织行病理学检查。结果 大鼠梗阻性黄疸模型建立后15d ,外周静脉和门静脉血浆中内毒素含量均明显升高(P <0 0 1) ,同时外周静脉血浆TNF α、IL 6含量、肠系膜淋巴结及肺组织细菌培养阳性率亦明显升高(P <0 0 1) ,并伴有肺泡腔出血水肿及大量炎性细胞浸润;乳糜管结扎显著降低外周血内毒素、TNF α、IL 6含量(P <0 0 1) ,明显减轻肺细菌易位率及肺病理损伤程度(P<0 0 1)。结论 阻断淋巴通道可减轻梗阻性黄疸时肠道细菌易位所致的高内毒素血症及炎症因子的过表达。 | 周新泽 毛勤生 倪耀辉 陈瑞新 于秀 陆丽萍 | 2005 | 中华普通外科杂志2005，20，4： | 2 |
| 3 | 结扎胸导管对食管癌术后肠道细菌内毒素移位的研究显示文摘目的探讨胸导管是否是术后禁食状态下肠道内毒素移位的主要途径。方法血样标本离心后取上清(血浆),双抗夹心酶联免疫法(双抗夹心ELISA法)测定内毒素含量,所得检测数据相应进行相关检验,分析结扎胸导管对血浆内毒素水平的影响,探讨胸导管是否为内毒素移位的主要途径。结果年龄和性别对血浆内毒素水平影响差异无统计学意义(P>0.05)。手术后第1~5天内,血浆内毒素水平有很大程度的升高(P<0.01)。食管癌患者术中结扎胸导管组术后血浆内毒素水平和未扎组比较结扎组明显低于未扎组(P<0.01)。结扎胸导管降低了术后血浆内毒素水平。结论预防结扎胸导管不仅可以预防术后乳糜胸的发生,而且对于阻断内毒素的移位有重要意义,胸导管可能是内毒素移位的主要途径。 | 武铁军 陈新 何明 杨利伟 白世祥 | 2010 | 河北医药2010，32，12： | 1 |
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