The Influence Of Intestinal Mucosal Permeability In Severe Burn Patients By Different Ways Of Glutamine Of Supplement

The burn is one kind of serious trauma,the organizations damage seriously.The patho-physiology change nearly involves all organization and the internal organs of human body after the burn.The gastro-intestinal tract is central organ in stress,is starting organ of the multiple organ dysfunction syndrome.The functional maintenance of intestinal mucosal barrier relies on the mucous membranate epithelium,the microbial population in intestinal tract,the endocritic of intestinal tract,the creeping motion,the intestinal correlative immunocyte and so on.The mucosa of intestinal epithelium to ischemic reperfusion is sensitive extremely,the oxygen free radical and the inflammatory factor and so on may lead to damage the function of intestinal mucosal barrier,cause to enhance the intestinal mucosal permeability.ObjectiveTo observe the urine lactulose mannitol ratio,plasma DAO and Gln concentration of serious burn patients by oral administration or intravenous injection of Glutamine,prove into the changes of intestinal mucosal permeability in severe burn patients and the influence of intestinal mucosal permeability by different ways of Glutamine of supplement.Method1.40 cases of serious burn patients with Total Burn Surface Area more than 40% to divide into the group of oral administration Glutamine(n=20)and the group of intravenous injection Glutamine(n=20).2.Two groups of patients accepted the early resuscitation,depth wound and eschar were shaved or excised,antibiotic application,prevent stress ulcer,and so on, observed and recorded patient's body temperature,the pulse,the breath,the blood pressure and so on.In the group of intravenous injection Glutamine,dosage of Glutamine was 0.3g·kg^-1·d^-1and group of oral administration Glutamine,dosage of Glutamine was 0.3g·kg^-1·d^-1. 3.The target determines:examined the lactulose mannitol ratio of two groups patients' urine,plasma DAO and glutamine concentration,carried on statistics comparative analysis.Probed into the influence of intestinal mucosal permeability in the serious burn patient by different ways of Glutamine of supplement.ResultThe urine L/M ratio and blood DAO of two group patients was increase.There was no difference in two group patients' plasma DAO and glutamine concentration and urine lactulose mannitol ratio.ConclusionThe urine L/M ratio and diamine oxidase concentration of two groups patients was increase,indicated that the intestinal mucosal permeability in serious burn patients was high,and the intestine barrier functional disturbance exist,because of ischemic damage.Glutamine by mouth and intervenous drop infusion can effectually elevate blood plasm Glutamine concentration,both of the two paths can shelter intestine barrier function.Glutamine by mouth accord with absorption and metabolism,pharmacoeconomics,and is cheaper.This investigate has the value of lightening patients' expenditure and rational administration.