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首页> 外文期刊>JPEN. Journal of parenteral and enteral nutrition. >Intestinal permeability after early postoperative enteral nutrition in patients with upper gastrointestinal malignancy.
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Intestinal permeability after early postoperative enteral nutrition in patients with upper gastrointestinal malignancy.

机译：上消化道恶性肿瘤患者术后早期肠内营养后的肠通透性。

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BACKGROUND: Increased intestinal permeability may lead to sepsis in resected upper gastrointestinal (GI) cancer patients. This study sought to determine whether these patients demonstrated increased intestinal permeability and if early postoperative enteral nutrition would alter this result. METHODS: Nineteen patients undergoing complete resection of upper GI malignancy were randomized into two groups: the nonfed group received IV crystalloid, and the fed group started enteral nutrition by jejunostomy on postoperative day (POD) 1. Six nonoperative volunteers were controls. The lactulose/mannitol test was performed on PODs 1 and 5. Ten grams of lactulose and 5 g of mannitol were given, and urine was collected for 6 hours. RESULTS: All patients (nonfed, 1.895+/-0.34; fed, 0.893+/-0.24) had elevated lactulose/mannitol ratios on POD 1 vs controls (0.262+/-0.1; p < .008 and p = .05). These elevated levels returned toward control levels in both groups by day 5 (nonfed, 0.533+/-0.1, p = .06; fed, 0.606+/-0.12, p = .08). CONCLUSIONS: Major upper GI surgery for malignancy resulted in a significant increase in intestinal permeability on POD 1. With or without enteral nutrition, this measure of intestinal permeability returned to normal on POD 5 in well-nourished patients.
机译：背景：增加的肠通透性可能导致切除的上消化道（GI）癌症患者发生败血症。这项研究试图确定这些患者是否表现出肠通透性增加以及术后早期肠内营养是否会改变这一结果。方法：将19例完全切除上消化道恶性肿瘤的患者随机分为两组：非进食组接受IV晶体注射，喂食组在术后第1天（POD）空肠造口术开始肠内营养。6名非手术志愿者为对照组。在POD 1和POD 5上进行了乳果糖/甘露醇测试。给出了10克乳果糖和5 g甘露醇，并收集了6个小时的尿液。结果：所有患者（非进食，1.895 +/- 0.34;进食，0.893 +/- 0.24）在POD 1上的乳果糖/甘露醇比值均高于对照组（0.262 +/- 0.1; p <.008和p = .05）。到第5天，两组的这些升高的水平又回到了对照水平（非进食，0.533 +/- 0.1，p = .06;进食，0.606 +/- 0.12，p = .08）。结论：恶性肿瘤的上消化道大手术导致POD 1的肠道通透性显着增加。无论是否有肠内营养，营养丰富的患者在POD 5上的这种肠通透性指标均恢复正常。

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