Gosain Ankush, Gamelli Richard L
Burn and Shock Trauma Institute, Department of Surgery, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA.
J Burn Care Rehabil. 2005 Jan-Feb;26(1):85-91. doi: 10.1097/01.bcr.0000150212.21651.79.
During the last 50 years, our understanding of the role of the gastrointestinal tract as a first-line defense against the development of postburn sepsis has increased dramatically. Starting with the concept of that gut-derived bacteria cause distant injury, investigators have delineated a complex series of physical changes in the barrier of the gastrointestinal tract. Along with an understanding of these physical changes has come an appreciation of the role of the immune system in modulating postburn organ failure. Importantly, recent investigations into the role of mesenteric lymph have fundamentally changed the paradigm of organ failure and have implicated the gut as a cytokine-secreting organ. This article traces the development of key concepts in the study of burn sepsis and their clinical implications.
在过去的50年里，我们对胃肠道作为烧伤后脓毒症发生的一线防御作用的理解有了显著提高。从肠道源性细菌导致远处损伤的概念开始，研究人员已经描绘出胃肠道屏障中一系列复杂的物理变化。随着对这些物理变化的理解，人们也认识到免疫系统在调节烧伤后器官功能衰竭中的作用。重要的是，最近对肠系膜淋巴作用的研究从根本上改变了器官功能衰竭的范式，并表明肠道是一个分泌细胞因子的器官。本文追溯了烧伤脓毒症研究中关键概念的发展及其临床意义。
