| ObjectiveTo determine whether combined early postoperative enteral feeding andrecombinant human growth hormone would inhibit the systemic inflammatory response, therefore increasing anastomotic healing in a peritonitis model.MethodsSD rats underwent cecal ligation and puncture to induce peritonitis, six hoursafter induction of peritonitis and ileoeolostomy was performed. In the experimentalgroup, rats also underwent gastrostomy. 48 rats were divided into three groups: thecontrol group, rats had access to water only after 24 hours and free access to foodand water after 3 days; the EN group, rats enteral nutrition was given after for 7days: the EN/GH group, the animals were treated as EN group, and growthhormone(3.0IU/kg/d) was injected intramuscularly every 24 hours for 7 days. Indexesof acute inflammatory response such as TNF-a and PLT were measured on the postoperativeday 3 and day 7. The hydroxyproline content and histology were measured as indicatorsof wound healing on the postoperative day 3 and day 7. The tissue at anastomotic siteof all groups were perform pathologic study on the postoperative day 3 and day 7.ResultsThe levels of TNF-a of the control group were higher than that of the experimental groups on postoperative the day 3, and P values were all lower than 0.01. The levelsof PLT of the control group were lower than that of the experimental groups onpostoperative the day 3, and P values were all lower than 0.01. The hydroxyprolineconcentration of the tissue at anastomotic site of the experimental groups were higherthan that of the control group on postoperative the day 3 and day 7, and that weresignificant. The hydroxyproline concentration of the EN/GH groups was higher thanthat of the EN group on postoperative the day 3 and day 7, and that were significant.The inflammatory response of the tissue at anastomotic site of the experimental groupswere lighter than that of the control group on postoperative the day 3 in pathologicstudy, and the intestinal mucosal epithelial cell proliferation, villus heightincrease and fibroblast increase of the EN/GH group were significant different withthe other two groups on day 7.ConclusionEarly postoperative enteral nutrition would inhibit the expression of the TNF-ain the peritonitis rats, so it modulate the systemic inflammatory response andtherefore increasing anastomotic healing. Recombinant human growth hormone wouldpromote anastomotic healing. Combined early postoperative enteral nutrition andrecombinant human growth hormone would modulate the systemic inflammatory response, and increasing anastomotic healing in a peritonitis model significantly. |
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