Parenteral versus early intrajejunal nutrition: Effect on pancreatitic natural course, entero-hormones release and its efficacy on dogs with acute pancreatitis

摘要

AIM: To evaluate the effect of early intrajejunal nutrition (EIN) on the natural course, entero-hormone secretion and its efficacy on dogs with acute pancreatitis. METHODS: An acute pancreatitis model was induced by injecting 1 ml/kg of combined solution (2.5 % sodium taurocholate and 8 000-10 000 BAEE units trypsin/ml) into the pancreas via pancreatic duct. Fifteen dogs were divided into parenteral nutrition (PN) group and EIN group. Two groups were isonitrogenous and isocaloric. EIN was used at postoperative 24 h. Serum glucose, calcium, amylase and lysosomal enzymes were determined before and 1, 4, 7 d after acute pancreatitis was induced. All the dogs were injected 50 uCi ~(125)I-BSA 4 h before sacrificed on the 7th day. The ~(125)I -BSA index of the pancreas/muscle, pancreas/blood, and pancreas pathology score (PPS) were determined. The peripheral plasma cholecystokinin (CCK), secretin (SEC) and gastrin were measured by ELISA and RIA, and was quantitative analysis of pancreatic juice and amylase, pancreatolipase and HCO_3~-, Cl~-, Na~+ and K~+ performed by an autochemical analyzer at 30, 60, 120 and 180 min after beginning PN or EIN on the first day. RESULTS: There was no difference between two groups in the contents of serum calcium, amylase and lysosomal enzymes, ~(125)I-BSA index of pancreas/muscle and pancreas/ blood and PPS. The contents of CCK and gastrin in EIN were higher than those in PN group at 60 and 120 min (P<0.05). The content of SEC post-infusion of nutrition solution was higher than that of pre-infusion of nutrition solution in both groups, and only at 60 min SEC in EIN group was higher than that in PN group. The content of gastrin in EIN was higher than that in PN group at 120 and 180 min (P<0.05). The changes of pancreatic juice, amylase, pancreatolipase and HCO_3~-, Cl~-, Na~+ and K~+ between two groups did not reach significantly statistical difference (P>0.05). CONCLUSION: EIN does not stimulate entero-hormone and pancreatic juice secretion, and enzyme-protein synthesis and release. EIN has no effect on the natural course of acute pancreatitis.