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胃肠道缺血性损伤的治疗

Treatment of gastrointestinal ischemic injury.

作者信息

Blikslager Anthony T

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh 27606, USA.

出版信息

Vet Clin North Am Equine Pract. 2003 Dec;19(3):715-27. doi: 10.1016/j.cveq.2003.08.004.

Abstract

Ischemic injury is one of the most important causes of mortality in equine veterinary medicine. Although treatment of reperfusion injury has been attempted in a number of experimental trials to reduce the level of injury subsequent to an ischemic episode, this research has not resulted in the development of useful clinical treatments. Nevertheless, recent studies assessing intraluminal application of solutions containing antioxidants, nutrients, and vasodilators are promising. Furthermore, focusing on improving mucosal recovery after an ischemic event may provide an alternative method of reducing mortality. Potential treatments include administration of basement membrane components like hyaluronic acid, gut-specific nutrients like glutamine, and early return to feeding to stimulate endogenous repair mechanisms. Finally, recent studies evaluating NSAIDs have revealed the potential of flunixin meglumine to retard the mucosal repair process, indicating the need for judicious use of this drug.

摘要

缺血性损伤是马兽医医学中最重要的死亡原因之一。尽管在许多实验性试验中尝试了对再灌注损伤进行治疗,以降低缺血发作后的损伤程度,但这项研究尚未带来有用的临床治疗方法。然而,最近评估含有抗氧化剂、营养物质和血管扩张剂的溶液腔内应用的研究很有前景。此外,专注于改善缺血事件后的黏膜恢复可能提供一种降低死亡率的替代方法。潜在的治疗方法包括给予透明质酸等基底膜成分、谷氨酰胺等肠道特异性营养物质,以及尽早恢复喂食以刺激内源性修复机制。最后,最近评估非甾体抗炎药的研究表明,氟尼辛葡甲胺有延缓黏膜修复过程的可能性,这表明需要谨慎使用这种药物。

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