中国实用外科杂志

中国实用外科杂志 ›› 2022, Vol. 42 ›› Issue (03): 355-357.DOI: 10.19538/j.cjps.issn1005-2208.2022.03.16

• 讲座 • 上一篇    下一篇

肠运动昼夜节律及其外科临床意义

潘华峰，王    刚，江志伟   

  1. 南京中医药大学附属医院普外科，江苏南京210002
  • 出版日期:2022-03-01 发布日期:2022-03-04

  • Online:2022-03-01 Published:2022-03-04

摘要： 肠运动存在昼夜节律，表现为白天活跃，夜间减弱或消失，这是一种内生性的、由时钟基因控制的生物节律。肠运动节律既可与中央节律保持高度一致，也可独立于中央节律而对外周环境刺激做出反馈。外科手术会破坏肠运动的昼夜节律，而围手术期合理使用褪黑素、五羟色胺（5-HT）受体激动剂和非甾体类解热镇痛药等药物则有助于促进此节律的恢复。外科医生了解肠运动节律的机制，有助于加深术后肠麻痹（POI）的认识，再基于时辰药理学，在合适的时机以适宜的剂量给药，或许能进一步缩短POI时间，促进肠运动功能尽早恢复。

关键词: 昼夜节律, 肠运动节律, 术后肠麻痹

Abstract: Circadian rhythm of intestinal motility and its surgical significance        PAN Hua-feng, WANG Gang, JIANG Zhi-wei. General surgery department of Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210002,China
Corresponding author：JIANG Zhi-wei,E-mail:surgery1@aliyun.com
Abstract    There is a circadian rhythm in intestinal motility，which is active during the day and weakened or disappears at night，and it is an endogenous biological rhythm controlled by clock genes.The intestinal motility rhythm can be highly consistent with the central rhythm or independent of the central rhythm and provide feedback to external environmental stimulation. The circadian rhythm of intestinal motility can be disrupted by surgery，but reasonable perioperative use of melatonin, 5-HT agonists and non-steroidal antipyretic analgesic can help to restore the circadian rhythm.Learning about intestinal motility rhythm mechanisms helps deepen the understanding of postoperative ileus (POI), which may be further shortened with appropriate dosage in an appropriate time based on chronopharmacology, thus promoting the early recovery of  intestinal motility.

Key words: circadian rhythm, intestinal motility rhythm, postoperative ileus