Serum Intestinal Fatty Acid Binding Protein Level Evaluation On Small Intestinal Trauma Surgery Prognosis

Purpose: The diagnosis of small intestine injury mainly depends on history, signs and imaging examination, and no the laboratory index has effective evaluation on small intestinal trauma surgery prognosis. Serum intestinal fatty acid binding protein(IFABP) exists only in the intestinal mucosa, mainly located in the small intestinal villus, with good organ specificity. I-FABP levels can reflect the degree of small intestine and mesenteric ischemia in early intestinal injury. The purpose of this study is to investigate the evaluation of serum I- FABP levels on the small intestine trauma surgery prognosis.Methods: 128 patients with small intestinal injury that needed to undergo surgery in our hospital were enrolled, ranging from July 2012 to March 2014. They were stratified into a study group with a preoperative serum I- FABP level higher than 300 ng/ml and a control group with a preoperative serum I- FABP level lower than 300 ng/ml. After the surgery, the maintenance of water and electrolyte stability, nutritional support, fasting, gastrointestinal decompression and application of antibiotics were carried out in the two groups. The level of I- FABP was measured at the first 7 days, the serum procalcitonin(PCT) level was measured at the first 3 days, and gastrointestinal function scores was performed. Exhaust and defecate time, postoperative hospitalization time, the numbers of intestinal obstruction were recorded.Results: Of 128 patients underwent surgery, 56 individuals with a preoperative serum I- FABP level higher than 300 ng/ml, and 72 individuals with a preoperative I- FABP level lower than 300 ng/ml. The level of serum I- FABP preoperative was higher than normal. The group with a preoperative serum I- FABP level higher than 300 ng/ml exhibited higher incidences of multiple injuries and mesenteric injury, shock index greater than 1 postoperative, and more often to be underwent small intestine excision anastomosis. By comparing the two groups, patients with a preoperative serum IFABP level less than 300 ng/ml have lower serum PCT level, shorter anus exhaust defecation time and lower incidence of intestinal obstruction, shorter hospitalization time(P <0.05). The level of serum I- FABP were gradually decreased postoperative at the first 7 days, the level of I- FABP and gastrointestinal function score were positively correlated(R 2=0.520, P <0.05).Conclusion: The level of serum I – FABP preoperative in small intestine trauma surgery patients can not only evaluate postoperative prognosis, but also predict the recovery function of intestinal postoperative. This discovery can be used to adjust the treatment plan in clinical.