胃肠功能衰竭的原因及分级治疗

胃肠功能衰竭常继发于各种危重疾病,如脓毒症、严重缺氧、严重消化道疾病,以胃肠道黏膜损害以及运动和屏障功能障碍为主要特点,是影响危重患者预后的重要因素,早期诊断与治疗对改善患者预后至关重要,但多年来由于缺乏明确特异性评估标准,临床无统一定义和诊断标准,也缺少统一治疗方案.近年来,国外成人ICU领域提出急性胃肠损伤新概念,根据胃肠损伤程度将胃肠功能障碍分为四级,并根据分级进行治疗,值得儿科医师借鉴.本文重点介绍胃肠功能衰竭的病因及分级诊疗新理念.

Etiology and grading treatment of gastrointestinal failure

Gastrointestinal failure is often secondary to a variety critically illness such as sepsis,severe hypoxia and severe gastrointestinal diseases and characterized gastrointestinal mucous lesion,dysfunction of gastrointestinal motility and barrier.It is a pivotal factor influencing the outcome of critically ill patients.Early diagnosis and appropriate treatment is important to improve the outcome of patients,but for a long time there was no unified definition and standard of diagnosis and also no consensus of therapeutic regimen because of lacking specific criteria of assessment.In recent years,the new conception of acute gastrointestinal injury with its four grades of severity and therapeutic regimen based on the grades were proposed in adult ICU field which is worth learning for pediatrician.In this review,the etiology of gastrointestinal failure and the new concepts on its different grades and grading treatment were discussed.