烧伤后肠道菌群变化的研究进展

Research progress on changes of intestinal flora after burn

烧伤是人体外伤最常见的原因之一,因体液失衡,疼痛重,易感染,病程长等原因,治疗过程中会出现多系统的并发症。烧伤后强烈的应急反应对消化系统影响较大。Curling溃疡在临床工作中经常被提及。除此以外,消化道的病症又影响着烧伤的整个治疗过程,如肠内营养支持,内源性感染等。除人体消化道器官病生变化外,消化道内的菌群也发挥了至关重要的作用。甚至将包括肠道菌群在内的消化系统被认为是人体的“第二神经中枢”。烧伤后肠道内有益菌的减少,有害菌的增加已被广泛认知,很早临床医师便指出可针对性应用益生菌,且取得了很好的效果,使患者受益。随着目前广泛而深入的研究,肠道菌群的秘密被逐步揭开。文章主要综述烧伤后肠道菌群变化的研究进展,从不同角度分析引发烧伤后肠道菌群失调的关键影响因素以及烧伤后肠道菌群失调对全身多系统,多器官可能带来的损伤,搜集整理了烧伤后肠道菌群失调的防治方法。提出烧伤后通过早期肠道营养,补充益生菌,消化道去污等综合性预防与治疗,可改善严重烧伤患者预后。肠道菌群的研究可能成为逆转烧伤多器官功能障碍的新靶向。

Burning is one of the most common causes of human trauma.Due to fluid imbalance,heavy pain,easy infection and long course of disease,there will be multi system complications in the treatment process.The strong emergency response after burning has a great impact on the digestive system.Curling ulcer is often mentioned in clinical work.In addition,gastrointestinal diseases affect the entire treatment process of burns,such as enteral nutrition support,endogenous infection and so on.In addition to the pathological changes of human digestive tract organs,the flora in the digestive tract also plays a vital role.Even the digestive system,including intestinal flora,is regarded as the"second nerve center"of the human body.The decrease of beneficial bacteria and the increase of harmful bacteria in the intestinal tract after burn have been broadly recognized.Clinicians pointed out that probiotics can be applied targeted for a long time,and achieved good results,benefiting patients.With the extensive and in-depth research,the secret of intestinal flora has been gradually revealed.Therefore,we searched the current relevant literature,reviewed the research progress of intestinal flora changes after burn,analyzed the key influencing factors of intestinal flora imbalance after burn from different angles,and the possible damage of intestinal flora imbalance after burn to multiple systems and organs of the whole body,and collected and sorted out the prevention and treatment methods of intestinal flora imbalance after burn.In addition,it is proposed that the prognosis of severe burn patients can be improved through comprehensive prevention and treatment such as primary intestinal nutrition,probiotics supplementation and gastrointestinal decontamination.We believe that the study of intestinal flora may become a new target to reverse burn multiple organ dysfunction.