The Effect Of Early Enteral Nutrition With Recombinant Human Growth Hormone On Severely Scalded Rats

Objective To explore the effect of early enteral nutrition(EEN) with recombinant human growth hormone(rhGH) on severely scalded rats. Methods 130 wistar rats were randomly divided into four groups, i.e. normal (N,n=10),control(C,n=40),early enteral nutrition(EEN,n=40) and early enteral nutrition with rhGH(EEN+rhGH,n=40).The rats in C,EEN and EEN+rhGH groups were inflicted with 30% TBSA â…¢ degree scalding on the back and the indices were observed on 1,3,5,9 postburn day (PBD)(n=10,respectively).Equal amount of calories were applied via free feeding to those in N and C groups or compulsory early enteral feeding to those in EEN and EEN+rhGH groups. The scalded rats were administered subcutaneously with normal saline(0.1ml/d) and rhGH(0.3u/kg.d) every evening, respectively in EEN and EEN+rhGH groups. The changes of body weight, morphology of ileal mucosa, serum endotoxin and serum TNFa and others were observed. Results 1 The body weight of those in C group decreased significantly on PBD1, PBD3, PBD5 and PBD9(P<0.05-0.01), The weight of those in EEN group decreased significantly on PBD3, PBD5 and PBD9(P<0.01),and The body weight of those in EEN+rhGH group decreased significantly only on PBD3 and PBD5(P<0.05-0.01). 2 Intestinal mucosalinjury and necrosis were observed in C group, and Intestinal mucosal inflammatory response was observed in EEN group. 3 The levels of serum endotoxin in C,EEN and EEN+rhGH groups were higher than that in N group (P<0.01),The levels of serum endotoxin in EEN and EEN+rhGH groups were lower than that in C group(P<0.01) ,and the level of serum endotoxin in EEN+rhGH groups was lower than that in EEN group.4 The levels of serum TNFa in C,EEN and EEN+rhGH groups were higher than that in N group (P<0.01), The level of serum TNFa in EEN group was lower than that in C group on PBD1, PBD5 and PBD9(P<0.01), and The level of serum TNFa in EEN+rhGH group were lower than that in C group (P<0.01) and lower than that in EEN group (P<0.05-0.01).5 The sizes of the wound in EEN+rhGH group were much smaller than those in C group and EEN group.Conclusion 1 aggressive early enteral postburn nutrition could protect the intestine , maintain its function, promote the growth of the mucosa and amelorate the inflammatory response and hypermatabolic response. 2 EEH with rhGH was prior to EEH in protecting the intestine , maintaining its function ,promoting the growth of the mucosa, ameliorating the inflammatory response and hypermatabolic response and promoting the wound healing.