• 四川大學(xué)華西醫(yī)院ICU(成都610041);

目的探討腸道細(xì)菌移位研究的進(jìn)展。
方法復(fù)習(xí)2000年至2005年6月關(guān)于腸道通透性的改變、腸道菌群失調(diào)和全身炎癥反應(yīng)綜合征(SIRS)的文獻(xiàn)。
結(jié)果隨著對SIRS和MODS的深入研究，越來越多的證據(jù)顯示，腸道不僅是MODS的靶器官，更是始動(dòng)器官。只有保證了腸道黏膜屏障的完整性，才能有效的預(yù)防腸道細(xì)菌移位。去除原發(fā)病，保證腸道的血供和氧供是最基本的治療方法。早期啟動(dòng)腸道、建立腸內(nèi)營養(yǎng)以及選擇性的腸道去污染也是有效的治療手段。
結(jié)論隨著對腸道細(xì)菌移位認(rèn)識(shí)的深入，我們的治療手段不斷豐富，可以更有效預(yù)防腸道細(xì)菌移位的發(fā)生，并阻止向SIRS和MODS進(jìn)一步發(fā)展。

引用本文： 肖菲,康焰. 腸道細(xì)菌移位的研究現(xiàn)狀. 中國普外基礎(chǔ)與臨床雜志, 2006, 13(2): 240-243. doi: 復(fù)制

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9. Demling RH. The clinical relevance of defining the mechanism for altered gut permeability in a “twohit”model of injury and infection [J]. Crit Care Med, 2004; 32(11)∶2356.
10. Choudhry MA, Rana SN, Kavanaugh MJ. Impaired intestinal immunity and barrier function: a cause for enhanced bacterial translocation in alcohol intoxication and burn injury [J]. Alcohol, 2004; 33(3)∶199.
11. 常建星.全身炎癥反應(yīng)綜合征與腸屏障的損害 [J]. 國外醫(yī)學(xué)·外科學(xué)分冊, 2004; 31(3)∶158.
12. 張良成. 創(chuàng)傷和失血性休克后腸道屏障功能不全及其與MODS發(fā)生的關(guān)系 [J]. 國外醫(yī)學(xué)·麻醉學(xué)與復(fù)蘇分冊， 2001； 22（4）∶237.
13. Berg RD, Garlington AW. Transplantation of certain indigenous from the gastrointerstinal tract to the mesenteric lymph nodes and other organs in a gnotobiotic mouse model [J]. Infect Immun, 1979; 23(2)∶403.
14. 石剛. 腸道黏膜屏障的損傷與保護(hù) [J]. 腸外與腸內(nèi)營養(yǎng), 2004; 11(1)∶61.
15. DeSouza DA, Greene LJ. Intestinal permeability and systemic infections in critically ill patients: effect of glutamine [J]. Crit Care Med, 2005; 33(5)∶1125.
16. Ding LA, Li JS. Gut in diseases: physiological elements and their clinical significance [J]. World J Gastroenterol, 2003; 9(11)∶2385.
17. Steinberg SM. Bacterial translocation: what it is and what it is not.
18. Luyer MD, Buurman WA, Hadfoune M, et al. Strainspecific effects of probiotics on gut barrier integrity following hemorrhagic shock [J]. Infect Immun, 2005; 73(6)∶3686.
19. 鄭躍杰, 段恕誠. 微生態(tài)失衡與內(nèi)源性感染 [J]. 中國實(shí)用兒科雜志, 2003; 18(5)∶302.
20. Lichtman SM. Bacterial [correction of baterial] translocation in humans [J]. J Pediatr Gastroenterol Nutr, 2001; 33(1)∶1.
21. 趙光俠. 胃腸道細(xì)菌移位、 胃液菌群變化與全身炎癥反應(yīng)綜合征 [J]. 小兒急救醫(yī)學(xué), 2003; 10(3)∶184.
22. Stefanov CS, Boyadzhiev NP, Uchikov AP. Enteral nutrition in sepsis patients.
23. Kell MR, Barry BD, Redmond HP. Systemic inflammatory response syndrome: a new direction?.
  1. 1. [J]. Am J Surg, 2003; 186(3)∶301.
  2. 2. [J]. Folia Med (Plovdiv), 2005; 47(1)∶11.
  3. 3. [J]. Ir J Med Sci, 2003; 172(1)∶7.
  4. 4. 尹軍霞， 林德榮. 腸道菌群與疾病 [J]. 生物學(xué)通報(bào), 2004; 39(3)∶26.
  5. 5. 董永綏. 腸道菌群失調(diào)、內(nèi)毒素與小兒胃腸功能障礙 [J]. 中國實(shí)用兒科雜志, 2001; 16(1)∶5.
  6. 6. Besselink MG， Timmerman HM， Buskens E, et al. Probiotic prophylaxis in patients with predicted severe acute pancreatitis (PROPATRIA): design and rationale of a doubleblind, placebocontrolled randomised multicenter trial [J]. BMC Surg, 2004; 4(1)∶12.
  7. 7. 吳國豪. 腸道屏障功能 [J]. 腸外與腸內(nèi)營養(yǎng), 2004; 11(1)∶44.
  8. 8. 李志軍, 湯日波, 張萬祥. 腸道屏障功能損害與SIRS／MODS的發(fā)生及其防治 [J]. 中國危重病急救醫(yī)學(xué), 2000; 12(12)∶766.
  9. 9. Demling RH. The clinical relevance of defining the mechanism for altered gut permeability in a “twohit”model of injury and infection [J]. Crit Care Med, 2004; 32(11)∶2356.
  10. 10. Choudhry MA, Rana SN, Kavanaugh MJ. Impaired intestinal immunity and barrier function: a cause for enhanced bacterial translocation in alcohol intoxication and burn injury [J]. Alcohol, 2004; 33(3)∶199.
  11. 11. 常建星.全身炎癥反應(yīng)綜合征與腸屏障的損害 [J]. 國外醫(yī)學(xué)·外科學(xué)分冊, 2004; 31(3)∶158.
  12. 12. 張良成. 創(chuàng)傷和失血性休克后腸道屏障功能不全及其與MODS發(fā)生的關(guān)系 [J]. 國外醫(yī)學(xué)·麻醉學(xué)與復(fù)蘇分冊， 2001； 22（4）∶237.
  13. 13. Berg RD, Garlington AW. Transplantation of certain indigenous from the gastrointerstinal tract to the mesenteric lymph nodes and other organs in a gnotobiotic mouse model [J]. Infect Immun, 1979; 23(2)∶403.
  14. 14. 石剛. 腸道黏膜屏障的損傷與保護(hù) [J]. 腸外與腸內(nèi)營養(yǎng), 2004; 11(1)∶61.
  15. 15. DeSouza DA, Greene LJ. Intestinal permeability and systemic infections in critically ill patients: effect of glutamine [J]. Crit Care Med, 2005; 33(5)∶1125.
  16. 16. Ding LA, Li JS. Gut in diseases: physiological elements and their clinical significance [J]. World J Gastroenterol, 2003; 9(11)∶2385.
  17. 17. Steinberg SM. Bacterial translocation: what it is and what it is not.
  18. 18. Luyer MD, Buurman WA, Hadfoune M, et al. Strainspecific effects of probiotics on gut barrier integrity following hemorrhagic shock [J]. Infect Immun, 2005; 73(6)∶3686.
  19. 19. 鄭躍杰, 段恕誠. 微生態(tài)失衡與內(nèi)源性感染 [J]. 中國實(shí)用兒科雜志, 2003; 18(5)∶302.
  20. 20. Lichtman SM. Bacterial [correction of baterial] translocation in humans [J]. J Pediatr Gastroenterol Nutr, 2001; 33(1)∶1.
  21. 21. 趙光俠. 胃腸道細(xì)菌移位、 胃液菌群變化與全身炎癥反應(yīng)綜合征 [J]. 小兒急救醫(yī)學(xué), 2003; 10(3)∶184.
  22. 22. Stefanov CS, Boyadzhiev NP, Uchikov AP. Enteral nutrition in sepsis patients.
  23. 23. Kell MR, Barry BD, Redmond HP. Systemic inflammatory response syndrome: a new direction?.