CAJ | 학술논문

目的探讨肠外瘘患者消化液中细菌与酶含量在体外的变化.方法收集1998年7月至2008年1月我院16例高位肠外瘘患者瘘出的新鲜消化液,分别在0、2、4h测定引流液中细菌数量、淀粉酶和脂肪酶的含量.将瘘出的消化液及时回输入远端肠道,同时在肠液回输的0、7、14 d测定患者血清中白蛋白、纤维连接蛋白、转铁蛋白、前白蛋白水平.结果消化液中细菌数量4h内无增加(F(0,2)=18 812.50,P＞0.05；F(0,4)=387 625.00,P＞0.05).消化液中淀粉酶含量(F(0,2)=190.60,P＞0.05;F(0,4) =631.75,P＞0.05)和脂肪酶含量(F(0,2)=204.10,P＞0.05；F(0,4)=1080.05,P＞0.05) 4h内无变化.肠液回输后患者血清中纤维连接蛋白[0、7、14 d分别为(152.80±16.50)、(167.27±20.54)、(227.05 ±45.36) mg/L; F(0,14) =74.24,P＜0.01; F(7,14)=59.78,P＜0.01]、转铁蛋白[0、7、14 d分别为(2.16 ±0.52)、(2.23 ±0.48)、(2.62±0.41) g/L; F(0,14) =0.46,P＜0.01; F(7,14) =0.39,P＜0.05]、前白蛋白[0、7、14 d分别为(177.74±45.14)、(194.04±49.33)、(232.11±79.57) mg/L；F(0,14) =54.37,P＜0.05]水平显著增加.结论肠外瘘患者消化液中细菌和酶含量在体外4h内无变化,肠液回输是安全有效的.
목적 탐토장외루환자소화액중세균여매함량재체외적변화.방법 수집1998년7월지2008년1월아원16례고위장외루환자루출적신선소화액,분별재0、2、4h측정인류액중세균수량、정분매화지방매적함량.장루출적소화액급시회수입원단장도,동시재장액회수적0、7、14 d측정환자혈청중백단백、섬유련접단백、전철단백、전백단백수평.결과 소화액중세균수량4h내무증가(F(0,2)=18 812.50,P＞0.05；F(0,4)=387 625.00,P＞0.05).소화액중정분매함량(F(0,2)=190.60,P＞0.05;F(0,4) =631.75,P＞0.05)화지방매함량(F(0,2)=204.10,P＞0.05；F(0,4)=1080.05,P＞0.05) 4h내무변화.장액회수후환자혈청중섬유련접단백[0、7、14 d분별위(152.80±16.50)、(167.27±20.54)、(227.05 ±45.36) mg/L; F(0,14) =74.24,P＜0.01; F(7,14)=59.78,P＜0.01]、전철단백[0、7、14 d분별위(2.16 ±0.52)、(2.23 ±0.48)、(2.62±0.41) g/L; F(0,14) =0.46,P＜0.01; F(7,14) =0.39,P＜0.05]、전백단백[0、7、14 d분별위(177.74±45.14)、(194.04±49.33)、(232.11±79.57) mg/L；F(0,14) =54.37,P＜0.05]수평현저증가.결론 장외루환자소화액중세균화매함량재체외4h내무변화,장액회수시안전유효적.
Objective To investigate the amount of bacteria and the expression of amylase and lipases in the drainage fluid in patients with intestinal fistulas with time courses.Methods The samples were collected from 16 patients with high intestinal fistulas from July 1998 to January 2008.The amounts of bacteria from the drainage fluid were measured 0,2 and 4 hours after taking out from the patients.At the respective time points,the intestinal juices were also collected to measure the amylase and lipase expressions.After reinfusion of succus entericus,thelevels of albumin,prealbumin,transferring,and fibronectin were measured at 0,7,and 14 days,Results There was no significant increase of bacteria in the drainage fluid within 4 hours ( F(0,2) =18 812.50,P ＞ 0.05 ; F(0,4) =387 625.00,P ＞ 0.05).and there was no change in the expressions of amylase ( F(0,2) =190.60,P ＞ 0.05 ;F(0,4) =631.75,P＞0.05) and lipase within 4 hours (F(0,2) =204.10,P＞0.05; F(0,4) =1080.05,P＞0.05).After succus entericus reinfusion,the fibronectin (F(0,14) =74.24,P ＜ 0.01 ; F(7,14) =59.78,P ＜0.01),transferring (F(0,14) =0.46,P ＜ 0.01 ; F(7,14) =0.39,P ＜ 0.05 ),and prealbumin ( F(0,14) =54.37,P ＜ 0.05) were increased significantly.Conclusions Bacteria and enzymes do not increase in the drainage fluid within 4 hours in patients with intestinal fistulas.Therefore,it is safe and effective to reinfuse succus entericus.