Yao V, Platell C, Hall J C
Department of Surgery, University of Western Australia, Perth, Australia.
Br J Surg. 2003 Oct;90(10):1187-94. doi: 10.1002/bjs.4373.
Peritoneal mesothelial cells have a remarkable capacity to respond to peritoneal insults. They generate an intense biological response and play an important role in the formation of adhesions. This review describes these activities and comments on their relationship to surgical drainage, peritoneal lavage and laparostomy in the management of patients with peritonitis.
Material was identified from previous review articles, references cited in original papers and a Medline search of the literature. The peritoneal mesothelium adapts to peritonitis by facilitating the clearance of contaminated fluid from the peritoneal cavity and inducing the formation of fibrinous adhesions that support the localization of contaminants. In addition, the fluid within the peritoneal cavity is a battleground in which effector mechanisms generated with the involvement of peritoneal mesothelial cells meet the contaminants. The result is a complex mix of cascading processes that have evolved to protect life in the absence of surgery.
Future advances in the management of patients with severe peritonitis may depend upon molecular strategies that modify the activity of peritoneal mesothelial cells.
腹膜间皮细胞对腹膜损伤具有显著的反应能力。它们会引发强烈的生物学反应，并在粘连形成过程中发挥重要作用。本综述描述了这些活动，并对其在腹膜炎患者管理中与手术引流、腹膜灌洗和剖腹术的关系进行了评论。
从先前的综述文章、原始论文中引用的参考文献以及对文献的医学数据库检索中确定了相关资料。腹膜间皮通过促进腹腔内污染液体的清除以及诱导形成支持污染物定位的纤维性粘连来适应腹膜炎。此外，腹腔内的液体是一个战场，在这个战场上，由腹膜间皮细胞参与产生的效应机制与污染物相遇。结果是一系列复杂的级联过程的混合，这些过程在没有手术的情况下进化而来以保护生命。
重症腹膜炎患者管理的未来进展可能取决于改变腹膜间皮细胞活性的分子策略。
