| Obstructive jaundice is a familiar disease in clinic with higherdeath rate and more complication than that of others withoutjaundice. Its cause is uncertain. Besides renal function failure,dystrophia and hyperbilirubinemia, multiple organs system failuredue to intestinal bacteria transposal, endotoxin and blood poisoningof gram-negative bacteria is still the main reason for complicationsand high death rate of patients of obstructive jaundice. Intestinalbacteria transposal is an important part in the field of nutritiontreatment study. Rational nutrition can not only adjust dystophiacondition of patients, but also strengthen immune capability ofeconomy and improve prognosis. Enteral nutrition is easier, saferand more acceptable by patients than parenteral nutrition.Moreover, it has remarkable advantage on maintaining intestinalmembrane barrier function over parenteral nutrition. Long term ofparenteral nutrition leads to injury of hepatic function, bile fill-upand much more metabolistic complications. So, only if intestinalfunction exists, enteral nutrition is prefered. Being lack of biliarysalt in obstructive jaundice, portal vein in liver pressed by enlargedcommon bile duct leads to suffocated intestinal veins, membraneedema. Intestinal ability of absorbing nutrition decreases. Clinicallythere is few certain treatment for what kind of nutrition method forobstructive jaundice patients, so is studies in this field. In this study,obstructive jaundice rats are given nutritional support. The purposeis to observe the effect of nutritional support on bacteria transposaland endotoxemia in superior mesenteric lymph nodes ofobstructive jaundice rats to supply proof for choosing suitablenutritional support in clinic.Purpose Obstructive jaundice rats are given nutrition support fromdifferent approaches to observe changes of morphology of rats'intestinal membrane and changes of bacteria transposal ofmesenteric lymph nodes and endotoxin content.Method 48 male SD rats (weight 250~300g) are randomly divided into:1 Fake operation group (SHAM) 12 rats; 2 Obstructive jaundicegroup (common biliary duct ligated, CBDL) 36 rats, includingsimple obstructive jaundice group (control: 12 rats), parenteralnutrition group (CBDL+TPN: 12 rats) and enteral nutrition(CBDL+EN: 12 rats). Under room temperature, mixed feedstuff isgiven to accommodate rats for surroundings. Model making ofCBDL and SHAM: all animals are induced to anaesthesia byintroceliac injection of 2% barbital sodium. Cut is located in themiddle of upper abdomen. After the first porta hepatis is exposed,the common biliary duct is dissociated bluntly. SHAM operationhas been completed by the end of this step without ligation ofbiliary ducts. In CBDL group, the common biliary duct is ligatedbilaterally to make complete obstruction of biliary ducts outsideliver. Model making of TPN: Cut is located in the right neck ofCBDL and superficial cervical vein is dissociated. A tunnel is madeby a No. 20 syringe needle through the cut to scapular region and avein catheter is led to the front of the neck from the back. Theremote end of superficial cervical vein is ligated. A cut is made inthe near end, through which the catheter is inserted 1.0~1.5 cmtowards heart direction. The catheter is ligated and fixed. The veincatheter from scapular region go through protective spring androtative equipment, and is connected to speed-limit transfusionpump. Nutrition support project: SHAM and CBDL control aregiven whole content feedstuff nutrition. EN and TPN are givenenteral nutrition and parenteral nutrition equal nitrogen energyrespectively 1 day after common biliary duct ligation. EN is givenNutrison fibre,and TPN is given all in one nutrition liquid. All arefed in the metabolism cage separately for 7 days. The gross energyis 693 KJ·Kg-1·d-1 [166kcalKg-1·d-1], content of nitrogen is1.05g·Kg-1·d-1. Ratio of non-protein energy and nitrogen is 140:1,and all rats are given water at ease in the experiment. Afterexperiment, blood of all rats from inferior vena cava is taken inasepsis to undergo test of endotoxin. In asepsis, lymph nodes ofmesenteric membrane, liver and spleen tissue are taken to bacteriaculturing. 2 cm intestinal tissue is cut 5 cm to ileocecum to undergopathological test observed with optic microscope.Result Except SHAM, intestinal membrane of other group becomesthin and shrinks, and villus is shorter, and epithelia are missingwith a number of inflammatory cells soaked in the inherent layer ofmembrane and shallower cave. Compared with SHAM, Bacteria...
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