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[术后腹膜炎患者肠内功能不全的发病机制]

[Pathogenesis of enteral insufficiency in patients with postoperative peritonitis].

作者信息

Uzankichian A A, Asatrian A R, Zakarian A E, Mkhitarian A G, Akopian G R, Pogosian G A, Zakarian Z A, Minasian A A

出版信息

Khirurgiia (Mosk). 2010(11):42-7.

Abstract

Enteral insufficiency is considered to trigger the syndrome of endogenous intoxication and, further, multiple organ failure. Enteral insufficiency often accompanies postoperative septic complications, such as peritonitis. Morphologic changes of the intestinal wall by septic peritonitis consisted of edema, fibrinous degradation of muscular layer and dystrophy of local nervous pathways. Microbiologic analysis of intestinal and gastric contents, peritoneal fluid and blood samples demonstrated a broad spectrum of pathogenic flora. Besides, enterotoxin allocated from blood and intestinal contents coincided in all cases. Adequate algorithm of detoxication, including extracorporal methods, had been worked out.

摘要

肠内功能不全被认为会引发内源性中毒综合征,进而导致多器官功能衰竭。肠内功能不全常伴有术后感染性并发症,如腹膜炎。感染性腹膜炎引起的肠壁形态学变化包括水肿、肌层纤维蛋白降解和局部神经通路营养不良。对肠道和胃内容物、腹膜液和血液样本的微生物学分析显示出广泛的致病菌群。此外,从血液和肠道内容物中分离出的肠毒素在所有病例中均一致。已经制定了包括体外方法在内的适当解毒算法。

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