活体小肠移植术后早期肠内营养对移植物结构和功能的意义

目的：观察我国首例父子间活体小肠移植受体，早期肠内营养对移植肠肠粘膜形态结构、粘膜屏障及移植肠吸收功能的影响。方法：应用图像分析、D-木糖吸收试验和血培养等方法测定和评价移植肠绒毛高度、绒毛表面积、D-木糖吸收率和肠道细菌移位。结果：术后7天移植肠绒毛高度、绒毛表面积显著缩短和缩小，但在第12天已开始恢复。在术后第38天完全脱离TPN时已恢复至移植前的近80%，D-木糖吸收率基本达正常水平，血培养始终为阴性。结论：活体小肠移植术后早期肠内营养不仅能促进移植肠的运动，而且能显著改善移植肠粘膜结构和吸收功能，有维护肠粘膜屏障功能的作用。

Effect of early enteral nutrition on mucosal structure and absorption of small bowel allograft

Objectives:To investigate the effect of early EN on mucosal structure and absorption function of allograft after living related small bowel transplantation. Methods:Early enteral nutrition was used.The image analysis,D xylose absorbtion test and blood culture were used to measure the villus height and area,D xylose absorption and bacterial translocation in blood. Results:The morphometric examination showed that villus height and villus area were decreased on the 7th postoperative day,began to increase on the 12th day after transplantation and had been the 80% of normal level.The percentage of D xylose absorption was gradually increased and reached the normal level on the postoperative 38th day.Postoperative blood cultures were always negative. Conclusions:Early EN support can improve the mucosal structure and absorption function of small bowel allograft after living related small bowel transplantation.