短肠综合征的病理生理改变及临床表现  

Pathophysiology and clinical manifestations of short bowel syndrome

作　　者：龚剑峰 Gong Jianfeng(Department of General Surgery,Nanjing Jinling Hospital,Medical School of Nanjing University,Nanjing 210002,China)

机构地区：[1]解放军东部战区总医院普通外科,南京210002

出　　处：《中华炎性肠病杂志（中英文）》2022年第1期22-26,共5页Chinese Journal of Inflammatory Bowel Diseases

基　　金：国家自然科学基金项目(81970469)。

摘　　要：短肠综合征(SBS)是指各种原因导致的小肠有效吸收面积不足,严重影响患者生活质量及远期生存的一组症状。随着近年对SBS病理生理机制的深入认识,该病的诊断治疗及其慢性并发症的管理均有进展。SBS分为末端空肠造口、空肠或回肠-结肠吻合、空肠-回肠吻合3种解剖类型,其术后演变可遵循急性期(高分泌期)、代偿期和维持期3个阶段。长期SBS可合并小肠细菌过度生长、高草酸尿症、代谢性骨病、肝胆疾病等慢性并发症。本文就各阶段、各类型SBS的病理生理及临床表现作一论述。Short bowel syndrome(SBS)refers to insufficient intestinal absorption due to various reasons,affecting the patient′s quality of life and long-term survival.With insight into the pathogenesis of SBS,the diagnosis,treatment and the management of its chronic complication have evolved.According to the anatomy,SBS could be divided into three types:jejunostomy,jejuno-ileocolic anastomosis,and jejuno-ileum anastomosis.The successful rehabilitation of SBS depends upon the management of the three phases:acute phase,adaptation phase,and maintenance phase.Besides malnutrition,the primary complications include bacterial overgrowth,nephrolithiasis due to hyperoxaluria,cholelithiasis,and intestinal failure-associated liver disease,etc.This review is intended to summarize the pathophysiological change and the clinical manifestation of different stages and types of SBS.

关 键 词：短肠综合征 肠衰竭 病理生理 炎症性肠病 

分 类 号：R574[医药卫生—消化系统]