Deitch E A
Louisiana State University Medical Center, Shreveport 71130-3930.
Arch Surg. 1990 Mar;125(3):403-4. doi: 10.1001/archsurg.1990.01410150125024.
Traditionally, evaluation of intestinal function has been limited largely to monitoring gastric pH and intestinal motility. This clinical approach has led clinicians to equate normal intestinal motility with normal intestinal function and to assume that if stress-induced gastric bleeding can be prevented, all will be well. However, it is becoming increasingly clear that the gastrointestinal tract is not a passive organ and that intestinal dysfunction is not limited to ileus and upper gastrointestinal bleeding. Instead, the gastrointestinal tract is recognized as having important endocrine, metabolic, immunologic, and barrier functions, as well as its traditional role in nutrient absorption. Over the last 5 years, there has been a resurgence of interest in the role of intestinal barrier failure in the development of systemic infection and multiple organ failure in the critically ill or injured patient.
传统上，肠道功能评估主要局限于监测胃pH值和肠道蠕动。这种临床方法使临床医生将正常的肠道蠕动等同于正常的肠道功能，并认为如果能预防应激性胃出血，一切就会顺利。然而，越来越清楚的是，胃肠道并非一个被动的器官，肠道功能障碍也不限于肠梗阻和上消化道出血。相反，胃肠道被认为具有重要的内分泌、代谢、免疫和屏障功能，以及其在营养吸收方面的传统作用。在过去5年里，人们对肠道屏障功能衰竭在危重症或受伤患者发生全身感染和多器官功能衰竭中的作用重新产生了兴趣。
