Effects of Gastrointestinal Postoperative Early Enteral Nutrition on the Intestinal Barrier Function

Objective:To observe the effect of early enteral nutrition (EEN) on intestinal barrier function after the gastrointestinal surgery. Methods: Using of prospective, randomized, double-blind and controlled method, sixty patients received gastrointestinal operations were randomly divided into two groups (30 for each). The experimental group received enteral nutrition 3-5 days after the operation and the control group received total parenteral nutrition(TPN) 3 days after the operation. The patients were administered with the above nutrients that contained equal energy and equal amount of nitrogen. After 3 d, 7 d and 14 d, respectively, patients were administered intestinal permeability test solution (contained 2 g lactulose and 1g mannitol). Six hours urine was collected and determined the urinary lactulose and mannitol concentration by LC-MS/MS method. Blood samples were collected 1 day before the operation and 1, 4 and 8 days postoperation to detect the plasma endotoxin level by using MB-80 Dynamic microbial system and EKT-5Mset Kit. Results: (1) L / M ratio in both two groups were higher at 8 d than at 3 d, and the ratios were higher in control group than in experimental group, but no significant difference was observed. After 14 d, the L / M ratio in control group was significantly higher than in experimental group (P0.01). (2) After 7d the plasma endotoxin in control group was gradually increased, but gradually decreased in experimental group. No significant difference was observed between the two groups (P0.01). Conclusion: Intestinal permeability will enhance because of traumatic stress early intestinal adhesion. Enteral nutrition can maintain the intestinal mucosal barrier function, EEN is beneficial to maintain intestinal barrier structure and function, balance intestinal flora, and consequently reduce endotoxemia.