[The morphological alterations of jejunal mucosa accepting early enteral nutrition for post-operative patients with severe acute pancreatitis].
OBJECTIVE
To investigate the morphological alterations and significances of jejunal mucosa responsible to post-operative patients with severe acute pancreatitis treated with enteral nutrition (EN) or total parenteral nutrition (TPN).


METHODS
40 patients were divided randomly into EN group and TPN group. The serum levels of prealbumin (PAB) and transferrin (TRF) were detected at a given time. Jejunal mucosa specimens were acquired through a new technique and observed in detail both under general microscope and electronic microscope.


RESULTS
On seventh and fourteenth post-operative day, the serum level of PAB in EN group was remarkably higher than it in TPN group (P < 0.05). No difference was seen in TRF levels of 2 groups. On 14th post-operative day, it was found by general microscope that the height of jejunal mucosa villi was significantly higher in EN group than in TPN group (P < 0.05), and meantime it was also found by electronic microscope that the height of microvilli on jejunal mucosa epithelial cells in EN group was remarkably higher than it in TPN group (P < 0.05) and was higher than microvilli itself before EN start (P < 0.05). In TPN group, some pathological alterations could be seen in jejunal mucosa epithelial cells on 14th post-operative day, such as mitochondrial edema, crista swelling, dilation of rough endoplasmic reticulum and nucleolus, and the appearance of abnormal substances in intercellular attachments. However, none of above these pathological changes could be seen in EN group.


CONCLUSIONS
Early enteral nutrition could protect the jejunal mucosa in post-operative patients with severe acute pancreatitis and have its results better than TPN alone.
Tian
Bo-Le
BL
Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Cao
Hong-Feng
HF
Hu
Wei-Ming
WM
Liu
Xu-Bao
XB
Han
Fang-Hai
FH
He
Man-Xi
MX
Li
Quan-Sheng
QS
Zhang
Zhao-Da
ZD
D000328:Adult; D000368:Aged; D004750:Enteral Nutrition / Q000379:methods*; D004847:Epithelial Cells / Q000378:metabolism / Q000473:pathology / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology* / Q000648:ultrastructure; D007583:Jejunum / Q000473:pathology*; D008297:Male; D008854:Microscopy, Electron; D008871:Microvilli / Q000378:metabolism; D008875:Middle Aged; D010195:Pancreatitis / Q000473:pathology* / Q000628:therapy*; D010288:Parenteral Nutrition; D011184:Postoperative Period; D011228:Prealbumin / Q000378:metabolism; D013997:Time Factors; D014168:Transferrin / Q000378:metabolism
D011228:Prealbumin; D014168:Transferrin