The influence of enteral nutrition on gut barrier in the post-operative patients with damaged hepatic function

Abstract

The safety, rationality and the practicality of enteral nutrition (EN) support in the postoperative patients with damaged hepatic function were investigated and the protective effect of EN on the gut barrier and the clinical implication studied. Seventy-six adult patients whose hepatic function were in Child B or C grade were randomly assigned in EN group (30 cases), total parenteral nutrition (TPN) group (26 cases) and control group (CON, 20 cases). The patients received different nutritional support. The signs of nutritional condition and hepatic function were messured at 1 day before, 5 days and 10 days after the surgical operation respectively. The changes in the urine lactulose (L) and mannitol (M) contents and L/M ratio were observed by using pulsed electrochemical detection (HPLC-PED) to acquire the different effects among the different nutritional support performance. The results showed that the patients in the EN group and TPN group had no worse hepatic function damage after operation. The patients in the EN group reached the positive nitrogen balance earlier, had a less weight loss than in the TPN group with the difference being significant (P < 0.05). There was no obvious change in L/M ratio in the postoperative patients in the EN group (P > 0.05), but there was significant difference in L/M between TPN group and CON group (P < 0.05). It was concluded that EN was a rational, safe, effective and practical nutrition support method in the patients with damaged hepatic function patients after surgical operation and EN can effectively protect the structure and function of gut barrier from sever infection.