Goulet O
Hôpital Necker-Enfants Malades, Paris, France.
Nutrition. 1998 Oct;14(10):784-7. doi: 10.1016/s0899-9007(98)00084-7.
The treatment of infants and children with short bowel syndrome aims at restoring the intestinal continuity and at improving the physiological process of gut adaptation. Mucosal hyperplasia allows the remaining gut to ensure an adequate digestion and an absorption process leading to intestinal autonomy. During the period of adaptation, appropriate parenteral and/or enteral feeding must be directed at maintaining an optimal nutritional status. Delay of intestinal autonomy depends on the characteristics of the residual intestine: length, presence of the ileocecal valve and colon, and motor function. Bacterial overgrowth compromises intestinal adaptation and increases the risk of liver disorders. Few patients will remain long-term dependent on parenteral nutrition. All approaches aimed at achieving intestinal autonomy should be tried: use of trophic factors, intestinal tapering, and lengthening. In a few residual patients, permanent intestinal failure or extreme short bowel syndrome require intestinal transplantation.
婴儿和儿童短肠综合征的治疗旨在恢复肠道连续性并改善肠道适应的生理过程。黏膜增生使剩余肠道能够确保充分的消化和吸收过程，从而实现肠道自主功能。在适应期，必须通过适当的肠外和/或肠内喂养来维持最佳营养状态。肠道自主功能的延迟取决于残余肠道的特征：长度、回盲瓣和结肠的存在情况以及运动功能。细菌过度生长会损害肠道适应并增加肝脏疾病的风险。很少有患者会长期依赖肠外营养。应尝试所有旨在实现肠道自主功能的方法：使用营养因子、肠道缩窄和延长。在少数残余患者中，永久性肠衰竭或极短肠综合征需要进行肠道移植。
