Misiakos Evangelos P, Macheras Anastasios, Kapetanakis Theodore, Liakakos Theodore
3rd Department of Surgery, University of Athens School of Medicine, Attikon University Hospital, Athens, Greece.
J Clin Gastroenterol. 2007 Jan;41(1):5-18. doi: 10.1097/01.mcg.0000212617.74337.e9.
Short bowel syndrome is a chronic malabsorptive state usually resulting from extensive small bowel resections. A combination of diarrhea, nutrient malabsorption, dysmotility, and bowel dilatation may constitute the clinical symptomatology of this syndrome. The remaining bowel undergoes a process called adaptation, which may replace lost intestinal function. Chronic complications include nutrient, electrolyte, and vitamin deficiencies. Therapy depends largely on the administration of various factors stimulating intestinal adaptation of the remaining bowel. If the patient despite medical therapy fails to return to oral diet alone, then long-term parenteral nutrition is required. However, long-term parenteral nutrition may gradually induce cholestatic liver disease. Surgical methods may be required for treatment including intestinal transplantation, as a last resort for the treatment of end-stage intestinal failure. The goal of this review is to analyze the clinical spectrum and pathophysiologic aspects of the syndrome, the process of intestinal adaptation, and to outline the medical and surgical methods currently used to treat this complicated group of patients.
短肠综合征是一种慢性吸收不良状态，通常由广泛的小肠切除引起。腹泻、营养物质吸收不良、动力障碍和肠扩张的组合可能构成该综合征的临床症状。剩余的肠道会经历一个称为适应的过程，这可以替代丧失的肠道功能。慢性并发症包括营养物质、电解质和维生素缺乏。治疗很大程度上取决于给予各种刺激剩余肠道肠适应的因素。如果患者尽管接受了药物治疗仍无法仅恢复经口饮食，那么就需要长期肠外营养。然而，长期肠外营养可能会逐渐诱发胆汁淤积性肝病。治疗可能需要手术方法，包括肠道移植，作为终末期肠衰竭治疗的最后手段。本综述的目的是分析该综合征的临床谱和病理生理方面、肠道适应过程，并概述目前用于治疗这一复杂患者群体的医学和手术方法。
