危重症患者肠衰竭诊断与评估的研究进展  

Research progress in the diagnosis and evaluation of intestinal failure in critically ill patients

作　　者：张小蝶 卢慕荣 凌冬兰 郭玮 杨帅[1] 于红静[2] Zhang Xiaodie;Lu Murong;Ling Donglan;Guo Wei;Yang Shuai;Yu Hongjing(Department of Intensive Care Unit,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510000,Guangdong,China;Department of Nursing,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510000,Guangdong,China)

机构地区：[1]广州医科大学附属第二医院重症医学科,广东广州510000 [2]广州医科大学附属第二医院护理部,广东广州510000

出　　处：《中国中西医结合急救杂志》2023年第2期245-249,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：中华医学会杂志社护理学科研究课题(CMAPH-NRI2021034);广州市海珠区科技计划项目(2022-11)。

摘　　要：肠道不仅可以消化吸收营养物质,同时还能够有效维持肠道菌群的稳定,防止肠道内细菌以及内毒素移位引起不良结局.肠衰竭是指肠实质与(或)其功能的损害导致消化、吸收营养与(或)黏膜屏障功能产生障碍,肠道功能下降到能吸收大量营养素及水和电解质所需的最低水平以下,需静脉补充以维持健康和(或)生长.对于危重症患者,在合并肠衰竭时,将增加不良预后的风险及病死率,是导致危重症患者死亡的主要原因,因此肠道功能状态已成为影响危重患者预后的重要指标之一,故对于肠衰竭的早期识别与预防有重要意义.现从危重症患者肠衰竭的定义与诊断、实验室早期预警指标、风险评估及预警等方面进行综述,以期提高医护工作者对危重症患者肠衰竭的综合认识,提升对危重症患者肠衰竭的关注度,为临床早期识别与预防提供参考依据.The intestine can not only digest and absorb nutrients but also effectively maintain the stability of intestinal flora and prevent the displacement of bacteria as well as endotoxins in the intestine that would cause adverse outcomes.Intestinal failure is defined as damage to the intestinal parenchyma and/or its function resulting in impairment of digestion,absorption of nutrients and/or mucosal barrier function,and a decline in intestinal function below the minimum level required to absorb large amounts of nutrients and/or water and electrolytes,needing intravenous supplementation to maintain health and/or growth.For critically ill patients,the combination of intestinal failure increases the risk of an unfavorable prognosis as well as mortality which is the main cause of death in critically ill patients,therefore the functional state of the intestine has become one of the most important indicators of the prognosis of critically ill patients,consequently,the early identification and prevention of intestinal failure is of great importance.This article will review the definition and diagnosis of intestinal failure in critically ill patients,laboratory early warning indicators,risk assessment and early warning,etc,in order to improve medical workers'comprehensive understanding of intestinal failure in critically ill patients,enhance the attention of critically ill patients with intestinal failure.It provides a reference for early clinical identification and prevention.

关 键 词：危重症 肠衰竭 胃肠功能障碍 综述 

分 类 号：R459.7[医药卫生—急诊医学]