Medical management of motility disorders in patients with intestinal failure: a focus on necrotizing enterocolitis, gastroschisis, and intestinal atresia
Medical management of motility disorders in patients with intestinal failure: a focus on necrotizing enterocolitis, gastroschisis, and intestinal atresia
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DOI：
10.1016/j.jpedsurg.2011.04.002
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发表时间：
2011-08-01
影响因子：
2.4
通讯作者：
Sigalet, David
中科院分区：
文献类型：
--
作者：
Dicken, Bryan J.;Sergi, Consolato;Sigalet, David
背景：肠衰竭（IF）是指依赖肠外营养维持生长发育所需的最低能量需求。它可能继发于肠道长度的损失，运动障碍，或两者兼而有之。短肠综合征（SBS）是由手术切除、先天性缺陷或与吸收表面积损失相关的疾病引起的吸收不良状态。特别令人烦恼的问题与全肠和/或节段性肠动力障碍有关。SBS和IF背景下的动力障碍可能与继发于肠长度损失的快速肠传输、与损失或不良顺行性舒张相关的动力障碍或胃轻瘫有关。治疗可分为医疗（促动力剂和抗溃疡剂）和外科手术来处理过度膨胀的运动不良bowelite.Methods：我们进行了一个系统的文献回顾，有关IF，SBS和动力障碍的小儿人群与腹裂，坏死性小肠结肠炎，肠闭锁。除了可用的治疗方案，我们提供了一个文献回顾和总结现有的evidence.Conclusion：尽管相对较差的证据水平的应用，促进和antiphilosheal药物治疗的SBS和IF患者，这些代理商继续使用。在此，我们提供了一个审查的生理学和病理生理学的肠动力/动力障碍和可用的策略，使用促进和抗腹泻剂的患者IF/SBS。(C)2011 Elsevier Inc. All rights reserved.
Background: Intestinal failure (IF) is the dependence upon parenteral nutrition to maintain minimal energy requirements for growth and development. It may occur secondary to a loss of bowel length, disorders of motility, or both. Short bowel syndrome (SBS) is a malabsorptive state resulting from surgical resection, congenital defect, or diseases associated with loss of absorptive surface area. A particularly vexing problem is associated with whole bowel and/or segmental intestinal dysmotility. Motility disorders within the context of SBS and IF may relate to rapid intestinal transit secondary to loss of intestinal length, dysmotility associated with loss or poor antegrade peristalsis, or gastroparesis. Therapy may be classified into medical (prokinetic and antidiarrheal agents) and surgical to deal with the overdistended poorly motile bowel.Methods: We performed a systematic review of the literature pertaining to IF, SBS, and dysmotility in the pediatric population with gastroschisis, necrotizing enterocolitis, and intestinal atresia. In addition to the available treatment options, we have provided a review of the literature and a summary of the available evidence.Conclusion: Despite relatively poor level of evidence regarding the application of promotility and antidiarrheal medications in patients with SBS and IF, these agents continue to be used. Herein, we provide a review of the physiology and pathophysiology of intestinal motility/dysmotility and available strategies for the use of promotility and antidiarrheal agents in patients with IF/SBS. (C) 2011 Elsevier Inc. All rights reserved.