Diagnostic Value Of Serum Citrulline And I-FABP In Intestinal Barrier Dysfunction 24 Hours After Radical Gastrectomy And Early Protection Of Intestinal Barrier

Objective:To study the effect of citrulline and I-FABP concentration changes on intestinal barrier dysfunction in 24 hours after radical gastrectomy,and the effect of glutamine on the two indexes of early warning and clinical outcomeMethods:60 patients who underwent radical gastrectomy from February 2018 to July 2019 were randomly divided into experimental group(30 cases)and control group(30 cases).The control group was given routine treatment in perioperative period,and the experimental group was given glutamine and probiotics on the basis of routine treatment in perioperative period.The changes of serum citrulline concentration,I-FABP,16SrDNA copy number of E.coli and clinical outcome were observed in the two groups 2 hours before operation and 24 hours after operation to explore the early-warning effect of citrulline and I-FABP on intestinal barrier dysfunction 24 hours after radical gastrectomy of gastric cancer To explore the effect of barrier damage,bacterial translocation and clinical outcome on gastrointestinal protection during perioperative period.Results:General data:there were 30 cases in the experimental group,12 males and 18 females,with an average age of 54.73±9.624,a body mass index of 21.14± 1.36,30 in the control group,16 males and 14 females,with an average age of 56.60±9.957 and a body mass index of 21.44 ± 1.54.There was no statistical significance in the sex,age and body mass index ratio of the experimental group.Methods:19 cases of laparoscopic gastrectomy,1 1 cases of open radical gastrectomy in the control group,and 12cases of open radical gastrectomy,18 cases of laparoscopic gastrectomy in the experimental group.I-FABP:In the control group,1142.67 ± 267.84pg/ml in the 2 hours before operation,1447.43 ± 300.14pg/ml in the 24 hours after operation,in the experimental group 1032.90± 340.36pg/ml in the 2 hours before operation,1139.16± 284.09pg/mlin the 24 hours after operation.The results of comparison of 16srDNA copy number:In the control group,3895.21±716.65copies/ml in the 2 hours before operation,4722.84±545.04copies/ml in the 24 hours after operation,in the experimental group 3764.93±835.49copies/mll in the 2 hours before operation,4340.07±862.96copies/ml in the 24 hours after operation.Citrulline:in the control group 23.13±7.3 1 umol/l in the 2 hours before operation,12.70±5.95umol/l in the 24 hours after operation,in the experimental group 24.47±7.43umol/1 in the 2 hours before operation,15.86± 5.76umol/l in the 24 hours after operation.Clinical outcome:in the control group,there were 0 cases of incision infection,0 case of abdominal infection,1 case of pulmonary infection,lcase of urinary tract infection,the average hospitalization time after operation was 11.27± 2.76 days,and the average hospitalization cost was 51165.82 ± 4662.08yuan.In the experimental group,there were 1 case of incision infection,0 case of abdominal infection,0 case of pulmonary infection,2 case of urinary tract infection,the average hospitalization time after operation was 10.03 ± 1.65 days,and the average hospitalization cost was 50848.36± 4781.51 yuan.Conclusion:(1)Radical gastrectomy can damage the intestinal barrier function.(2)The changes of serum citrulline and I-FABP in 24 hours after operation have a certain early warning effect on intestinal barrier dysfunction.(3)Early enteral nutrition of glutamine and probiotics has protective effect on intestinal barrier function,reducing postoperative incision infection,abdominal infection,lung infection,hospitalization cost and other clinical outcomes.