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接受大型胃肠道手术患者的细菌移位及其在术后脓毒症中的作用。

Bacterial translocation in patients undergoing major gastrointestinal surgery and its role in postoperative sepsis.

作者信息

Doudakmanis Christos, Bouliaris Konstantinos, Kolla Christina, Efthimiou Matthaios, Koukoulis Georgios D

机构信息

Department of General Surgery, General Hospital of Larissa, Larisa 41221, Greece.

出版信息

World J Gastrointest Pathophysiol. 2021 Nov 22;12(6):106-114. doi: 10.4291/wjgp.v12.i6.106.

Abstract

Bacteria of the human intestinal microflora have a dual role. They promote digestion and are part of a defense mechanism against pathogens. These bacteria could become potential pathogens under certain circumstances. The term "bacterial translocation" describes the passage of bacteria of the gastrointestinal tract through the intestinal mucosa barrier to mesenteric lymph nodes and other organs. In some cases, the passage of bacteria and endotoxins could result in blood stream infections and in multiple organ failure. Open elective abdominal surgery more frequently results in malfunction of the intestinal barrier and subsequent bacterial translocation and blood stream infections than laparoscopic surgery. Postoperative sepsis is a common finding in patients who have undergone non-elective abdominal surgeries, including trauma patients treated with laparotomy. Postoperative sepsis is an emerging issue, as it changes the treatment plan in surgical patients and prolongs hospital stay. The association between bacterial translocation and postoperative sepsis could provide novel treatment options.

摘要

人类肠道微生物群的细菌具有双重作用。它们促进消化,并且是抵御病原体的防御机制的一部分。在某些情况下,这些细菌可能会成为潜在的病原体。“细菌移位”一词描述了胃肠道细菌穿过肠黏膜屏障到达肠系膜淋巴结和其他器官的过程。在某些情况下,细菌和内毒素的移位可能导致血流感染和多器官功能衰竭。与腹腔镜手术相比,开放性择期腹部手术更常导致肠屏障功能障碍以及随后的细菌移位和血流感染。术后脓毒症在接受非择期腹部手术的患者中很常见,包括接受剖腹手术治疗的创伤患者。术后脓毒症是一个新出现的问题,因为它会改变手术患者的治疗方案并延长住院时间。细菌移位与术后脓毒症之间的关联可能会提供新的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dda9/8611185/015a979687df/WJGP-12-106-g001.jpg

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