Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita-city, Osaka, 565-0871, Japan,
Dig Dis Sci. 2013 Jan;58(1):23-32. doi: 10.1007/s10620-012-2334-x. Epub 2012 Aug 19.
The gut is an important target organ for stress caused by severe insults such as sepsis, trauma, burn, shock, bleeding and infection. Severe insult to the gut is considered to have an important role in promoting infectious complications and multiple organ dysfunction syndrome. These are sequelae of interactions between deteriorated intestinal epithelium, the immune system and commensal bacteria. The gut is the "motor" of multiple organ failure, and now it is recognized that gut dysfunction is a causative factor in disease progression. The gut flora and environment are significantly altered in critically ill patients, and the number of obligate anaerobes is associated with prognosis. Synbiotic therapy is a combination of probiotics and prebiotics. Probiotic, prebiotic and synbiotic treatment has been shown to be a promising therapy to maintain and repair the gut microbiota and gut environment. In the critically ill, such as major abdominal surgery, trauma and ICU patients, synbiotic therapy has been shown to significantly reduce septic complications. Further basic and clinical research would clarify the underlying mechanisms of the therapeutic effect of probiotic/synbiotic treatment and define the appropriate conditions for use.
肠道是严重损伤（如败血症、创伤、烧伤、休克、出血和感染）引起的应激的重要靶器官。严重的肠道损伤被认为在促进感染性并发症和多器官功能障碍综合征方面具有重要作用。这些是恶化的肠上皮、免疫系统和共生细菌之间相互作用的后果。肠道是多器官衰竭的“发动机”，现在人们认识到肠道功能障碍是疾病进展的一个致病因素。危重病患者的肠道菌群和环境发生了明显改变，专性厌氧菌的数量与预后相关。合生素治疗是益生菌和益生元的联合治疗。益生菌、益生元和合生治疗已被证明是维持和修复肠道菌群和肠道环境的一种有前途的治疗方法。在危重病患者中，如大腹部手术、创伤和 ICU 患者，合生素治疗已被证明可显著降低脓毒症并发症。进一步的基础和临床研究将阐明益生菌/合生治疗的治疗效果的潜在机制，并确定其使用的适当条件。
