Hydroxyethyl Starch On Colorectal Cancer Bowel Wall Permeability Influence Postoperative Clinical Research

Hydroxyethyl starch on colorectal cancer bowel wall permeability influence postoperative clinical researchObjective:People intestinal mucosa area is about 400m2, play in absorption function and immune function at the same time, most of them with the environmental photograph contact with external area;The contents of its contact include bacteria/toxins and its product, with many the happening of the disease development has important connection, directly affecting the patients with clinical outcomes.Intestinal mucosa refers to the intestinal can prevent inside harmful substances such as bacteria and bacterial endotoxin through the bowel glues the film inside other tissues and organs and blood of the institutions and function. Normally, intestinal not only has the digestive food, absorb nutrition functions, but also with intestinal mucous function, can prevent bacteria and toxins and harmful substances to enter the body, avoid cause bacteremia even systemic inflammatory response syndrome (SIRS) and multiple organ failure (MODS). Gastrointestinal not but easy to be hurt target organs,while still in multiple organ failure happened play an important role in development by calls multiple organ failure power device, or inspire systemic inflammation response syndrome is one of the valve. The intestinal mucosa directly or indirectly injury mucosal permeability is cause bowel source bacteria, endotoxin shift main reasons. Various basic and clinical research in recent years gradually established intestinal barriers failure and enterogenous systemic infections theory, Intestinal mucosa is closely related with intestinal permeability, burns, trauma, surgeries, serious infection etc all can cause intestinal mucosa impairment, the bowel glues the film permeability increase, bacteria and bacterial endotoxin namely can go through injury intestinal mucosa tissue entry and blood, produced bacterial endotoxin shift, into the organization, the bacteria and blood circulation and endotoxin in turn again in the intestinal mucosa, role further aggravating intestinal mucosa damage, leading to increased bowel wall permeability continue, and thus form vicious circle, even happen systemic inflammation response syndrome and multiple organ failure syndrome. Therefore, in various stress condition, to effectively to bowel barrier function of extensive research scholars both at home and abroad that protect a the object.Colorectal cancer incidence rates are higher in recent years, surgery is its radical means. Studies have confirmed that trauma, operation etc stress conditions, bacteria and bacterial endotoxin available through mucosa invades extra-intestinal tissues, causing intestinal flora and endotoxin shift, cause systemic inflammation response syndrome, even multiple organ failure syndrome. So if the critically ill and the surgery patients’ bowel wall permeability is monitored, understand their intestinal mucous function condition and to reduce the bowel wall permeability treatment, to reduce patient complications, promote the patient recover some important role. In clinical we will try to reduce the damage to bowel barrier function, reduce the bowel wall on bacteria and bacterial endotoxin permeability, reduce the incidence of complications, promote the patient’s recovery. This study aims to use hydroxyethyl starch on colorectal cancer patients who underwent the effect of permeability of the intestines, lower the permeability of patients, and promote bowel bowel function, reduce the patients recover complications, favors the patients follow-up rehabilitation.Method:Choose 2010 August and December 2010 my branch hospitalization colorectal cancer and do patients with colorectal surgery 60 cases, including colon cancer 21 cases, restal cancer 39; Age range 35-72, with an average age of 61 years old. Experimental group and the control group, were randomly divided into 30 cases of every group;Normal with patients in 10 (used to compare).Two groups of preoperative and normal control group were using mannitol and lactulose check the wiggle permeability;The postoperative vein give hydroxyethyl starch intervention (10mL·kg-1·d-1, continuous five days,use other treatment, with control group), The control group given without any routine therapy (not colloidal solution, only give crystalloid).Two groups of postoperative on the third and fifth day detection kidney function, electrolyte, hemoglobin, on the fifth day if bowel function recovered using lactulose and mannitol testing permeability, simultaneously recording bowel function recovery time. Results:(1)normal lactulose/mannitol (L/M) average(0.027±0.011); The preoperative experimental group lactulose/mannitol average (0.036±0.025), postoperative lactulose/mannitol average (0.046±0.021); The control group preoperative lactulose/mannitol average (0.032±0.028), postoperative lactulose/mannitol average (0.064±0.017); (2) the average recovery time bowel function for (80.5±12.7h), and controls group the average recovery time bowel function for (94.3±14.4h), (3) postoperative experimental group and control group plasma albumin decreased, the control group dropped degree above group. Experimental results show that:①Group and control group than normal bowel wall permeability preoperative group increased (P<0.05), but no significant difference between them (P>0.05),②the experimental group and the control group all the bowel wall permeability increased, but the control group than the obvious increase degree(P<0.05).③bowel function obviously experimental recovery time is shorter than the control group (P<0.05).④experimental and control group after surgery decreased, but plasma albumin significantly higher than the control group dropped (P<0.05). Conclusion: 1. Colorectal cancer patients pre-existent intestinal mucous function obstacle, than normal bowel wall permeability of high; 2. Colorectal operation injury intestinal mucous function, bowel wall permeability increase; 3. Colorectal surgery can not reduce routine therapy bowel wall permeability; 4. Colorectal cancer postoperative use hydroxyethyl starch therapy can improve bowel mucous function, reduce the bowel wall permeability, ascension plasma albumin, shorten the time, the bowel function recovery saved using plasma products.