中国实用外科杂志

中国实用外科杂志

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慢性假性肠梗阻诊断与治疗

陈启仪1，姜    军2   

  1. 1同济大学附属第十人民医院结直肠病专科/肠道微生态诊疗中心，上海 200072；2东部战区总医院普通外科研究所，江苏南京210002
  • 出版日期:2019-12-01 发布日期:2019-12-23

  • Online:2019-12-01 Published:2019-12-23

摘要： 慢性假性肠梗阻（CIPO）是一种罕见但严重的肠道运动障碍性疾病，其特征是在无机械性肠梗阻情况下肠运动功能受到损害。CIPO可能由于原发性和继发性因素损害肠神经系统（神经病变），平滑肌（肌病）和（或）Cajal间质细胞（间质病）所致。CIPO易漏诊和误诊，治疗极其困难，主要基于营养支持、药物和外科治疗。目前肠道微生态在CIPO中的发生、发展及治疗中的作用日益受到关注，可能成为CIPO新的治疗方法。

关键词: 慢性假性肠梗阻, 肠平滑肌, 肠神经系统, Cajal间质细胞, 小肠细菌过度繁殖

Abstract: Diagnosis and treatment of chronic intestinal pseudo-obstruction        CHEN Qi-yi*,JIANG Jun. *Shanghai Tenth People’s Hospital, Tenth People’s Hospital of TongJi University, Shanghai 200072, China
Corresponding author：JIANG Jun，E-mail：jiangjun6987@163.com
Abstract    Chronic intestinal pseudo-obstruction （CIPO）is a rare but serious intestinal dyskinesia characterized by impaired bowel motor function in the absence of mechanical intestinal obstruction.  CIPO may be caused by primary and secondary factors that damage the enteric nervous system（neuropathy），smooth muscle（myopathy），and/or Cajal interstitial cells（interstitial disease）. CIPO is extremely easy to missed diagnosis and misdiagnosis.The treatment of CIPO is very difficult.It is based on nutritional support，medicine and surgical treatment.At present，the occurrence，development and treatment of intestinal micro-ecology in CIPO has gradually attracted attention and may become a new treatment method for CIPO.

Key words: chronic intestinal pseudo-obstruction, intestinal smooth muscle, enteric nervous system, Cajal interstitial cells, small intestine bacterial overgrowth