危重症患者胃肠功能评估的研究进展

Progress in Research on Gastrointestinal Function Assessment in Critically ill patients

胃肠道损伤在危重病的多器官功能障碍综合征和多器官功能衰竭的发病机制中具有重要作用,胃肠功能障碍为多脏器功能障碍的始动因素。多项研究表明,危重症病房中高达62%患者存在胃肠功能障碍,其中近20%存在3种或3种以上胃肠道症状或体征,亦越来越多的临床证据表明,危重症患者的不良预后与胃肠道疾病的进展息息相关,包括并发症增加和生存率降低。然而,ICU患者胃肠功能难以评估,衡量急性胃肠损伤的指标既不敏感也不特异。近年来,危重症患者胃肠功能受到愈多临床医师的重视。胃肠功能障碍是胃肠功能衰竭的早期表现,病情可逆,若早期发现,给予合理干预治疗,可改善预后。

Gastrointestinal tract injury plays an important role in the pathogenesis of multiple organ dysfunction syndrome and multiple organ failure in critically ill patients.Gastrointestinal dysfunction is the initiating factor of multiple organ dysfunction.A number of studies have shown that up to 62%of patients in critical care wards have gastrointestinal dysfunction,of which nearly 20%have three or more gastrointestinal symptoms or signs,and more and more clinical evidence indicates that critically ill patients The poor prognosis is closely related to the progression of gastrointestinal diseases,including increased complications and reduced survival.However,gastrointestinal function is difficult to assess in ICU patients,and indicators for measuring acute gastrointestinal damage are neither sensitive nor specific.In recent years,the gastrointestinal function of critically ill patients has received more attention from clinicians.Gastrointestinal dysfunction is an early manifestation of gastrointestinal failure,and the condition is reversible.If it is found early,reasonable intervention can improve the prognosis.