胃腸道缺血性損害在多器官功能障礙綜合征發生中的作用_《中國普外基礎與臨床雜志》

作者：

張連陽綜述王正國 , 朱佩芳審校

第三軍醫大學大坪醫院野戰外科研究所(重慶 400042);

關鍵詞：

多器官功能障礙綜合征胃腸道缺血

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目的明確在多器官功能障礙綜合征(MODS)發病中胃腸道缺血性損害的作用。
方法復習近年來的有關文獻。
結果嚴重創傷、失血性休克等導致的胃腸道血流量減少，粘膜內pH降低，以及腸道細菌過度生長等可引起腸粘膜通透性增加、內毒素血癥和細菌移位。缺血還可使胃腸道粘膜產生TNF、IL-6等細胞因子，導致胃、小腸和結腸動力障礙，并激活中性粒細胞導致局部和遠隔臟器損傷。
結論通過補液擴容、早期腸道營養、促進胃腸道動力等方法積極糾正胃腸道缺血，改善腸屏障功能，有助于防治MODS。

引用本文： 張連陽綜述王正國,朱佩芳審校. 胃腸道缺血性損害在多器官功能障礙綜合征發生中的作用. 中國普外基礎與臨床雜志, 2001, 8(3): 200-201下轉封四. doi: 復制

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2.	Vincent JL. Prevention and therapy of multiple organ failure 〔J〕. World J Surg,1996； 20∶465.
3.	Sauaia A, Moore FA, Moore EE, et al. Early risk factors for postinjury multiple organ failure 〔J〕. World J Surg,1996； 20∶392.
4.	Hebra A, Hong J, McGowan KL, et al. Bacterial translocation in mesecteric ischemiareperfusion injury is dysfunctional motility the link〔J〕? Pediatric Surg,1994； 29(2)∶280.
5.	Marshall JC. The gut as a potential trigger of exerciseinduced inflammatory responses 〔J〕. Can J Physiol Pharmacol,1998； 76(5)∶479.
6.	Landow L, Andersen LW. Splanchnic ischemia and its role in multiple organ failure 〔J〕. Acta Anaesthesiol Scand, 1994； 38(7)∶626.
7.	Beuk RJ, Heineman E, Tangelder GJ, et al. Effects of different durations of tatol warm ischemia of the gut on rat messnteric microcirculation 〔J〕. J Surg Res,1997； 73(1)∶14.
8.	Charpentier C, Audibert G, Dousset B, et al.Is endotoxin and cytokine release related to a decrease in gastric intramucosal pH after hemorrhagic shock 〔J〕? Intensive Care Med,1997； 23(10)∶1040.
9.	Morales J, Kibsey P, Thomas PD, et al. The effects of ischemia an ischemiareperfusion on bacterial translocation, lipid peroxidation, and gut histology: studies on hemorrhagic shock in pigs 〔J〕. J Trauma, 1992; 33(2)∶221.
10.	Nieuwenhuijzen GA, Deitch EA, Goris RJ. The relationship between gutdervied bacteria and the development of multiple organ dysfunction syndrome 〔J〕. J Anat,1996； 189(3)∶537.
11.	Nieuwenhuijzen GA, Deitch EA, Goris RJ. Infection, the gut and the development of the multiple organ dysfunction syndrome 〔J〕. Eur J Surg, 1996； 162(4)∶259.
12.	EavesPlyles T, Alexander JW. Rapid and prolonged impairment of gut barrier function after thermal injury in mice 〔J〕. Shock, 1998； 9(2)∶95.
13.	Grotz MR, Deitch EA, Ding J, et al.Intestinal cytokine response after gut ischemia:role of gut barrier failure 〔J〕. Ann Surg,1999； 229(4)∶478.
14.	Yassin MMI, Barros AAB, Parks TG, et al.Lower limb ischaemiareperfusion injury alters gastrointestinal structure and function 〔J〕. Br J Surg,1997； 84∶1425.
15.	Tamion F, Richard V, Lyoumi S, et al. Gut ischemia and mesenteric systhesis of inflammartory cytokines after hemorrhagic or endotoxic shock 〔J〕. Am J Physiol, 1997； 273(Pt 1)∶G314.
16.	Sorkine P, Szold O, Halpem P, et al.Gut decontamination reduces bowel ischemiainduced injury in rats 〔J〕. Chest, 1997； 112(2)∶491.
17.	Mishima S, Xu Dazhong, Lu Qi, et al. Bacterial translocation is inhibited in inducible nitroxide synthase knockout mice after endotoxin challenge but not in a model of bacteri overgrowth 〔J〕. Arch Surg, 1997; 132∶1190.
18.	Hotokezaka M, Mentis EP, Patel SP,et al. Recovery of gastrointestinal tract motility and myoelectric activity change after abdominal surgery 〔J〕. Arch Surg,1997； 132(4)∶410.
19.	Udassin R, Eimerl D, Schiffman J, et al.Postischemic intestinal motility in rat is inversly correlated to length of ischemia:an in vivo animal model.〔J〕 Dig Dis Sci, 1995； 40∶1035.
20.	Tumage RH, Kadesky KM, Rogers T, et al.Neutrophil regulation of splanchin blood flow after hemorrhagic shock. 〔J〕 Ann Surg,1995； 222(1)∶66.
21.	Walley KR, Friessen BP, Humer MF, et al.Small bowel tonometry is more accurate than gastric tonometry in detecting gut ischemia 〔J〕. J Appl Physiol,1998； 85(5)∶1770.
22.	Bengmark S, Gianotti L. Nutritional support to prevent and treat multiple organ failure 〔J〕. World J Surg,1996； 20∶474.
23.	Rowlands BJ, Gardiner KR. Nutritional modulation of gut inflammation 〔J〕. Proc Nutr Soc, 1998； 57(3)∶395.
24.	Wang XD, Soltesz V, Andersson R. Cisapride prevents enteric bacterial overgrowth and translocation by improvement of intestinal motility in rats with acute liver failure 〔J〕. Eur Surg Res,1996； 28∶402.
25.	Spapen HD, Duinsiaeger L, Diltoer M, et al. Gastric emptying in critically ill patients is accelerated by adding cisapride to a standard enteral feeding protocol: results of a prospective, randomized, controlled trial 〔J〕. Crit Care Med,1995； 23(3)∶481.

1. Swank GM, Deitch EA. Role of the gut in multiple organ failure: bacterial translocation and permeability changes 〔J〕. World J Surg,1996； 20(4)∶411.
2. Vincent JL. Prevention and therapy of multiple organ failure 〔J〕. World J Surg,1996； 20∶465.
3. Sauaia A, Moore FA, Moore EE, et al. Early risk factors for postinjury multiple organ failure 〔J〕. World J Surg,1996； 20∶392.
4. Hebra A, Hong J, McGowan KL, et al. Bacterial translocation in mesecteric ischemiareperfusion injury is dysfunctional motility the link〔J〕? Pediatric Surg,1994； 29(2)∶280.
5. Marshall JC. The gut as a potential trigger of exerciseinduced inflammatory responses 〔J〕. Can J Physiol Pharmacol,1998； 76(5)∶479.
6. Landow L, Andersen LW. Splanchnic ischemia and its role in multiple organ failure 〔J〕. Acta Anaesthesiol Scand, 1994； 38(7)∶626.
7. Beuk RJ, Heineman E, Tangelder GJ, et al. Effects of different durations of tatol warm ischemia of the gut on rat messnteric microcirculation 〔J〕. J Surg Res,1997； 73(1)∶14.
8. Charpentier C, Audibert G, Dousset B, et al.Is endotoxin and cytokine release related to a decrease in gastric intramucosal pH after hemorrhagic shock 〔J〕? Intensive Care Med,1997； 23(10)∶1040.
9. Morales J, Kibsey P, Thomas PD, et al. The effects of ischemia an ischemiareperfusion on bacterial translocation, lipid peroxidation, and gut histology: studies on hemorrhagic shock in pigs 〔J〕. J Trauma, 1992; 33(2)∶221.
10. Nieuwenhuijzen GA, Deitch EA, Goris RJ. The relationship between gutdervied bacteria and the development of multiple organ dysfunction syndrome 〔J〕. J Anat,1996； 189(3)∶537.
11. Nieuwenhuijzen GA, Deitch EA, Goris RJ. Infection, the gut and the development of the multiple organ dysfunction syndrome 〔J〕. Eur J Surg, 1996； 162(4)∶259.
12. EavesPlyles T, Alexander JW. Rapid and prolonged impairment of gut barrier function after thermal injury in mice 〔J〕. Shock, 1998； 9(2)∶95.
13. Grotz MR, Deitch EA, Ding J, et al.Intestinal cytokine response after gut ischemia:role of gut barrier failure 〔J〕. Ann Surg,1999； 229(4)∶478.
14. Yassin MMI, Barros AAB, Parks TG, et al.Lower limb ischaemiareperfusion injury alters gastrointestinal structure and function 〔J〕. Br J Surg,1997； 84∶1425.
15. Tamion F, Richard V, Lyoumi S, et al. Gut ischemia and mesenteric systhesis of inflammartory cytokines after hemorrhagic or endotoxic shock 〔J〕. Am J Physiol, 1997； 273(Pt 1)∶G314.
16. Sorkine P, Szold O, Halpem P, et al.Gut decontamination reduces bowel ischemiainduced injury in rats 〔J〕. Chest, 1997； 112(2)∶491.
17. Mishima S, Xu Dazhong, Lu Qi, et al. Bacterial translocation is inhibited in inducible nitroxide synthase knockout mice after endotoxin challenge but not in a model of bacteri overgrowth 〔J〕. Arch Surg, 1997; 132∶1190.
18. Hotokezaka M, Mentis EP, Patel SP,et al. Recovery of gastrointestinal tract motility and myoelectric activity change after abdominal surgery 〔J〕. Arch Surg,1997； 132(4)∶410.
19. Udassin R, Eimerl D, Schiffman J, et al.Postischemic intestinal motility in rat is inversly correlated to length of ischemia:an in vivo animal model.〔J〕 Dig Dis Sci, 1995； 40∶1035.
20. Tumage RH, Kadesky KM, Rogers T, et al.Neutrophil regulation of splanchin blood flow after hemorrhagic shock. 〔J〕 Ann Surg,1995； 222(1)∶66.
21. Walley KR, Friessen BP, Humer MF, et al.Small bowel tonometry is more accurate than gastric tonometry in detecting gut ischemia 〔J〕. J Appl Physiol,1998； 85(5)∶1770.
22. Bengmark S, Gianotti L. Nutritional support to prevent and treat multiple organ failure 〔J〕. World J Surg,1996； 20∶474.
23. Rowlands BJ, Gardiner KR. Nutritional modulation of gut inflammation 〔J〕. Proc Nutr Soc, 1998； 57(3)∶395.
24. Wang XD, Soltesz V, Andersson R. Cisapride prevents enteric bacterial overgrowth and translocation by improvement of intestinal motility in rats with acute liver failure 〔J〕. Eur Surg Res,1996； 28∶402.
25. Spapen HD, Duinsiaeger L, Diltoer M, et al. Gastric emptying in critically ill patients is accelerated by adding cisapride to a standard enteral feeding protocol: results of a prospective, randomized, controlled trial 〔J〕. Crit Care Med,1995； 23(3)∶481.

《中國普外基礎與臨床雜志》

胃腸道缺血性損害在多器官功能障礙綜合征發生中的作用

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《中國普外基礎與臨床雜志》

胃腸道缺血性損害在多器官功能障礙綜合征發生中的作用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料