美国胃肠病协会(AGA)所发布短肠综合征临床实践指导意见解读  

Interpretation of American Gastroenterological Association(AGA) clinical practice guidelines for short bowel syndrome

作　　者：丁佐佑 刘皓 程雨曦 谈善军[1] 吴国豪[1] DING Zuo-you;LIU Hao;CHENG Yu-xi;WU Guo-hao(Shanghai Clinical Nutrition Research Center,General Surgery,Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院普通外科、上海市临床营养研究中心,上海200032

出　　处：《中国实用外科杂志》2023年第1期59-65,共7页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.81900484);上海市“医苑新星”青年医学人才培养资助计划(沪卫人事[2022]65号);复旦大学附属中山医院优秀青年人才计划(No.2021ZSYQ14)。

摘　　要：短肠综合征(SBS)是由于疾病和(或)手术切除导致的肠道长度严重缩短、肠道面积显著减少的一种临床综合征。近年来,得益于对SBS病理机制认识的加深、肠外营养(PN)和小肠移植等技术的进步以及新治疗理念的兴起,SBS病人的预后有了显著改善,病人的生活质量和生存率显著提高。近期,美国胃肠病协会(AGA)组织专家更新了SBS临床处理的指导意见,旨在提供涵盖SBS处理原则的最佳实践建议,规范SBS的临床管理。该指导意见根据公开有效的医学证据,结合最近发表的系统综述和临床指南,从肠道解剖、营养评估、饮食、PN、口服补液、药物治疗、药物剂量、手术治疗、并发症预防等方面提出了12条在SBS诊治方面极为实用的建议。Short bowel syndrome(SBS) is a clinicopathological syndrome resulting from the loss of intestinal length and area due to disease or surgical resection.Over the last years,the prognosis of SBS patients has remarkably improved with the increase in patients’ quality of life and survival,mainly thanks to the deepen understanding of pathogenesis of SBS,advances in multimodality therapy including parenteral nutrition(PN) and intestinal transplantation,and new treatment concept.Recently,experts from American Gastroenterological Association(AGA)have updated the guidelines on the clinical management of SBS,aiming to provide best practice advices covering the principles of SBS management and standardize the management of SBS.Based on available published evidence,with reference to recently published systematic reviews and clinical guidelines,this article has proposed 12 best practice advices including bowel anatomy,nutrition assessment,diet,PN,oral rehydration solution,pharmacologic therapy,drug dosing,surgery,and prevention of complications.

关 键 词：短肠综合征 肠衰竭 代谢 营养治疗 

分 类 号：R6[医药卫生—外科学]