| The hepatic cirrhosis is a familiar chronic liver disease.The liver is organin the center of sugar,protein and fat metabolism.The amount of liver cells isreduced and metabolism dysfunction in cirrhotic liver,so that it will be morethan50%reduction in serum albumin synthesis,resulting in hypoproteinemia,abnormal plasma colloid osmotic pressure,the lack of some hormones andtrace elements. The homeostasis is affected. Therefore,the oxidation of energyand nutrients metabolism occur significant changes.The regulatory function isreduced when the patient is malnourished. The oxidative decomposition of fatand energy is increased, protein and fat mobilization increased.When theoccurrence of ascites and other complications,it will lead to furtherdeterioration in nutritional status. Malnutrition in liver cirrhosis disease isalmost universal. Patients with liver cirrhosis (LC) often suffer from aprogressive loss of fat and muscle,resulting in mixed protein-caloriemalnutrition (PCM). The prevalence of PCM in LC could be as high as90%depending on the severity of the disease and the population examined. In theESPEN guidelines it is stressed that identifying those cirrhotic patients that aretruly malnourished is of great clinical importance because enteral nutritionimproves nutritional status and liver function, reduces complications,prolongssurvival and is therefore recommended.The nutritional support plays animportant role in the treatment of cirrhosis. Malnutrition has gradually beenacknowledged as an important prognostic factor which can influence theclinical outcome of patients suffering from end-stage liver disease. Despite thefact that malnutrition is not included in the Child–Pugh classification,itspresence should alert clinicians to the same extent as do other complications,such as ascites and hepatic encephalopathy.To improve the nutritional statusof patients with cirrhosis is very important. Since the mid-1980s,people have a new understanding on bowelfunction,that the intestine is an important immune organ.It is about60%of thelymphocytes in the intestinal tract.Meanwhile mucosal barrier can blockbacteria and endotoxin transfers outward.When the mucosal injured,bacteriaand endotoxin into the parenteral lymphoid and Department of venacava,causing the production of cytokines and inflammatory responses.Endotoxin not only in itself can damage liver cells, but also induce systemicmetabolic and hemodynamic disorders, participating in the occurrence anddevelopment of various complications,having a serious impact on theprognosis of patients with cirrhosis. Thus, the intestinal tract is one of thecenter organ in the body's stress response. Enteral nutrition in clinical patientswith cirrhosis, is not only to choose the way of nutritional support, even moresignificant is to maintain the integrity of intestinal mucosa in structure andfunction to prevent infection and increase hepatic blood.Enteral nutrients iaabsorbed into the liver through intestinal, to synthetize the various componentsneeded in the liver, in line with normal physiological processes, economic,security, fewer complications, and appetite stimulation of the intestinal tract isconducive to the prevention of intestinal mucosal atrophy, stimulate theproliferation of intestinal mucosa, protecting and enhancing the gut mucosalimmune barrier function, prevention of spontaneous bacterial peritonitiscaused by intestinal flora shift. Some of the ingredients of the enteral nutrientsmay be directly used by the intestinal mucosa, and promote the metabolismand proliferation of the intestinal mucosa.In recent years, enteral nutrition has been widely used in the internationalarea, with enteral nutrients varieties developed continuously,enteral nutritionis more convenient, the effect is more significant, not only can improve thenutritional status of patients, but alsocan improve the cure rate of patients,effectively reducing the average cost of hospitalization. It is a wise to givenenteral nutrition in Critically ill patients. However, in severely ill patients,supplemental enteral nutrition is advisable. According to the ESPENrecommendations, patients that cannot meet their caloric requirements through oral food intake, despite adequate individualized nutritional support, arecandidates for supplemental enteral nutrition. The use of whole proteinformulae in malnourished patients and the intake of more concentratedhigh-energy formulae in patients with ascites are recommended.From clinical practice in recent years,we found that the cirrhotic patientswere benefit from enteral nutrition.The amount of enteral nutrition that weregiven cirrhosis individual is difficult to unity,and the influencing factors aretoo many.Therefore,we choiced rats to the experimental study,with standardand objective data to explain the clinical phenomenon.Objective: In patiants with cirrhosis,tube feeding improves nutritionalstatus and liver function,reduces the rate of complications and prolongssuevival.3So nutrition support plays an very important role in patients withtreatment. This research will compare the ordinary diet group and enteralnutrition group with the change of liver function and nutrition index,toinvestigate the effects of enteral nutrition on liver function and nutritionalstatus in obstructive jaundice cirrhosis model of rats.Methods：The model was established in the Wastar rats by bile ductligation,30male Wistar rats were randomly divided into3groups,two groupare given the bile duct ligation operation,the other is not ligted bile duct: groupA,cirrhotic enteral nutrition group(n=10),receiving enteral nutritionNUTRITION; group B, cirrhotic control group(n=10),receiving ordinarydiet bought from He Bei Medical University; group C,controlgroup(n=10).After making cirrhosis model success,draw blood sampling2-3ml by the posterior orbital vein plexus from every rat.The rats were fedwith corresponding food for two weeks,then put to death. Preserved serumsamples to test liver function and nutrition index:TP,albumin,transferrin,TB (total bilirubin), ALT, AST.Preserved liver tissues to stain withhaematoxylin-eosin(HE),and MI(mitotic index) were determined.Results:1. After the model is succeed,giving rats enteral nutrition, Nutrison group ratsare better than ordinary diet group.in the mental state, activity and the degree of abdominal distension.2.The ordinary diet group and Nutrison group rats showed no significantdifference on ALT,AST,TB and A in forth weeks,are higher than controlgroup. The normal diet group and Nutrison group rats showed no significantdifference on A,TP and Transferrin in forth weeks,are lower than normalcontrol group.3.In sixth weeks at the end of experiment, the ordinary diet group andNutrison group rats showed nosignificant difference on ALT,AST,TB and A.The normal diet group and Nutrison group rats showed no significantdifference on A,TP and Transferrin,but there is significant difference inprealbumin.4.The liver tissue of Nutrison group is higher than the normal diet group inmitotic index.ComparedConclusion：Almost all the cirrhotic rats are malnutrition and differentdegree of damage in liver function.Application of nutrition as oral food incirrhotic rat,the liver function and nutrition index will be covered in a certainextent,the regeneration of liver will be enhanced. |
PDF Full Text Request