Clinical Study On Early Intervention Of Bacterial Translocation In Children With Severe Appendicitis

Objectives To explore changes in the level of immune function by bacterialtranslocation ,early intervention and clinical significance of Alanyl-glutamine enhancedparenteral nutrition on bacterial translocation in critically ill children with severe appendicitis.Methods Divided children into two groups according to severity ,with acute suppurativeappendicitis and perforation ,the merger of generalized peritonitis, intestinal obstruction,abdominal abscess or multiple early septic shock as severe group, the limitations peritonitis ofacute suppurative appendicitis as an ordinary group,Two groups of children receivingantibiotics which was based on the same level, while,the severe group was addedalanyl-glutamine (1.5ml/kg.d) enhanced parenteral nutrition , treatment for 7 daysconventionally,two groups of all children before surgery，7d after the operation peripheralvenous blood were taken respectively 5ml,PCR detection of bacteria in whole blood; Isolatemononuclear cells (MNC) by density gradient centrifugation , added Anti-CD3, CD4 and CD8monoclonal antibodies to the anticoagulant, at dark room for 30 min, fixed after dark to standfor 30 min, and finally by flow cytometry (BD) detection of T (CD3 +), Th (CD3 + CD4 +), Ts(CD3 + CD8 +), Th / Ts (CD4 + / CD8 +), Monitored of blood series and observed in patientswith postoperative complications, gastrointestinal function, liver function and nutritional supportfor the treatment of adverse reactions.Result Preoperative the 16SrRNA-positive rate and the BG-positive rate in severe group wasincreased compared with which in common group ,postoperative, .there was no significantdifference between two groups，Preoperative T,Th,Th/Ts of the severe group lower than normallevel(P<0.05), postoperative the severe group was more significantly (P <0.05),postoperative twogroups returned to normal, there was no significant difference between two groups(P> 0.05),preoperative Ts of severe group were significantly lower than the ordinary group (P <0.05) ,there was no significant difference between two groups(P> 0.05);postoperative , two levels wasno significant difference(P> 0.05); Preoperative WBC and C-reactive protein were increasedcompared with normal levels, postoperative two groups of white blood cells were returned tonormal, the level of CRP were more obvious reduced compared with ordinary group(P <0.05).Liver function and Kidney function did not change significantly before and after surgery.Conclusion In the early intervention Alanyl-glutamine enhanced parenteral nutrition incritically ill children with severe appendicitis prevent and treat bacterial translocation, reduce the intestinal damage, enhance immune to promote postoperative recovery and especially the wayis simple practical and less complications.