Wilmore D W, Robinson M K
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02146, USA.
World J Surg. 2000 Dec;24(12):1486-92. doi: 10.1007/s002680010266.
The short bowel syndrome is a symptom complex that occurs in adults who have less than 200 cm of jejunum-ileum remaining after intestinal resection. Similar symptoms are observed in infants and children following massive bowel resection or congenital anomalies and in individuals with longer segments of intestine with severe mucosal disease. Initial care should focus on a thorough excision of nonviable bowel, an exact measurement of the remaining viable bowel, placing all intestine in continuity at the initial or subsequent operation, and controlling initial food intake. With time, adaptation of the remnant intestine occurs, and absorptive function may be maximized by enhancing the enteral diet and minimizing parenteral nutrition. Growth factors and specialized nutrients may also enhance this process. Intestinal transplantation should be considered in selected individuals with the short bowel syndrome who fail intestinal rehabilitation protocols.
短肠综合征是一种症状复合体,发生于肠道切除术后空肠 - 回肠剩余长度不足200厘米的成年人。在婴儿和儿童进行大量肠道切除术后或患有先天性异常时,以及在患有较长肠段严重黏膜疾病的个体中也观察到类似症状。初始治疗应着重于彻底切除无活力的肠段、精确测量剩余有活力的肠段、在初次或后续手术中将所有肠段连接起来,以及控制初始食物摄入量。随着时间推移,残余肠道会发生适应性变化,通过增加肠内营养并减少肠外营养,吸收功能可最大化。生长因子和特殊营养素也可能促进这一过程。对于肠道康复方案失败的短肠综合征特定个体,应考虑进行肠道移植。