【摘要】 目的　探讨早期肠内营养 (EEN)联合重组人生长激素 (rhGH)对严重烫伤大鼠的治疗作用。　方法　Wistar大鼠 130只 ,随机分为正常组 (N组 ,10只 )、对照组 (C组 ,4 0只 )、EEN组 (40只 )、EEN +rhGH组 (40只 ) ,后 3组均给予背部 30 %TBSAⅢ度烫伤 ,于伤后第 1、3、5、9天 4个时相点称重后处死取血 ,检测白细胞数量及血红蛋白、总蛋白、白蛋白浓度 ,分离血清测定内毒素、肿瘤坏死因子(TNF)α含量 ,并取部分回肠肠管行形态学观察。另测定N组以上各指标 ,作为对照。　 结果 (1)体重 :与各组的伤前值比较 ,伤后C组体重下降最明显 (P <0.0 5 ),EEN +rhGH组回升最快。 (2 )血清内毒素水平 :EEN组和EEN +rhGH组在各时相点显著低于C组 (P <0.0 1);EEN +rhGH组在各时相点低于EEN组 ,但差异无显著性意义 (P >0.0 5 )。(3)TNFα水平 :EEN组和EEN +rhGH组在各时相点显著低于C组 (P <0.0 5～ 0.0 1);EEN +rhGH组在伤后第 3、9天显著低于EEN组 (P <0.0 5～ 0.0 1)。(4 )总蛋白浓度 :伤后 9dEEN +rhGH组显著高于EEN组 (P <0.0 5)。(5)白蛋白、血红蛋白浓度 :各组在各时相点差异无显著性意义 (P >0.0 5)。(6)C组肠黏膜坏死脱落 ,EEN组肠黏膜出现炎症反应 ,EEN +rhGH组绒毛高度明显高于其他组。　结论　严重烫伤后施行EEN?更多还原

【Abstract】 Objective To evaluak the therapeutic effects of early enteral nutrition(EEN) togather with recombinant human growth hormone(rhGH) on severely scalded rats. Methods One hundred and thirty Wistar rats were randomly divided into four groups, i.e. normal (group N,n=10),control(group C,n=40),early enteral nutrition(group EEN,n=40) and early enteral nutrition with rhGH(group EEN+rhGH,n=40).The rats in C,EEN and EEN+rhGH groups were subgected to 30% TBSA Ⅲ degree scald on the back.The changes in body weight, hemoglobin, white blood cell count, total protein, albumin,morphology of ileal mucosa, serum levels of endotoxin and TNFα were observed on 1,3,5,9 postburn day (PBD). Results (1) The rat body weight in C group decreased significantly (P<0.05～0.01),while that in EEN+rhGH group recovered more rapidly than that in other groups.( 2 ) The serum endotoxin levels in EEN and EEN+rhGH groups were lower than that in C group(P<0.01) ,while that in EEN+rhGH groups was slightly lower than that in EEN group. (3)The serum TNFα levels in EEN group and EEN+rhGH group were lower than that in C group (P<0.01), while that in EEN+rhGH group was lower than that in EEN group on 3 and 9 postburn days(PBDs) (P<0.05～0.01). (4)The serum levels of total protein in EEN+rhGH group was higher than that in EEN group on 9 PBD(P<0.05).(5)The serum levels of albumin and blood hemoglobin levels exhibited no obvious differences among all the groups.(6)Intestinal mucosal injury and necrosis were only observed in C group. Imflammatory reaction was observed in EEN group, and the villous height in EEN+rhGH group was obviously higher than that in the other groups. Conclusion The structure and function of intestine in severely scalded rats could be maintained and the hypermetabolism reaction could be alleviated by early enteral nutrition,and EEN togather with rhGH seemed fohave better resulls than that of EEN alone.更多还原