摘要
目的总结重症急性胰腺炎(SAP)时肠屏障功能障碍(IBD)的发病机理、检测方法及治疗进展。方法复习近年来国内、外有关SAP时IBD方面的文献并进行综述。结果SAP时IBD的发病机理涉及多个环节,缺血/再灌注损伤、内毒素、炎症介质、胃肠激素等起关键作用。IBD的检测有多种方法,尿乳果糖/甘露醇比值和血浆二胺氧化酶是相对理想的指标。积极治疗SAP,维持肠道灌注是治疗IBD的基础,并在此基础上合理运用促胃肠动力药、营养支持、中药等治疗。结论IBD是一个复杂的病理生理过程,近年来大量动物实验和临床研究结果为其的防治提供了新思路,但具体参与其中的细胞、分子的作用机理有待于进一步研究。
Objective To summarize the recent progress in pathogenetic, diagnostic and therapeutic researches on the intestinal harrier dysfunction （IBD） of severe acute pancreatitis （SAP）. Methods The advancement of IBD in SAP, which was published recently at home and abroad, was collected and reviewed. Results The pathogenesis of IBD in patients with SAP was complex. Ischemia-reperfusion injury, endotoxin, inflammatory mediators and gastrointestinal hormone played an important role in the process of IBD. There were many ways to detect IBD, and the ratio of lacmlose and mannitol, plasma diamine oxidase were relatively ideal markers. Medical therapies, such as treatment of SAP and maintaining the perfusion of intestines, were essential to cure IBD. On this basis, the propulsives, nutritional support and traditional Chinese drugs should be administered reasonably. Conclusions IBD is a sophisticated process of pathophysiology. In recent years, abundant of animal experiments and clinical resear ches have provided new clue for prevention and cure of IBD, but further researches are still needed on the mechanism of the cells and molecules implicated.
出处
《中国普外基础与临床杂志》
CAS
2009年第7期588-592,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
重症急性胰腺炎
肠屏障功能障碍
细菌移位
内毒素移位
Severe acute pancreatitis
Intestinal barrier dysfunction
Bacterial translocation
Endotoxin
