【结直肠癌术后分流性结肠炎的发病机制及诊治进展】。

Q3 Medicine
Z W Zhang, Y J Ye, Z L Shen
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引用次数: 0

摘要

导流性结肠炎(DC)是肠分流手术后远端肠缺乏粪便流刺激引起的一种非特异性炎症。主要与肠道菌群失调、短链脂肪酸缺乏、免疫异常等因素有关。导流性结肠炎的临床表现包括腹痛、粘液血便、腹泻等症状,但多数患者可能无明显症状。诊断主要依靠内镜检查和病理特征。常见的内镜表现为粘膜充血、水肿、脆性增加,组织学表现主要为淋巴滤泡增生。需要排除其他肠道炎症性疾病。治疗方案包括手术和保守的药物治疗,其中造口逆转是恢复肠道连续性最有效的治疗方法。对于不能接受手术的患者,可采用SCFA、5-氨基水杨酸(5-ASA)、类固醇或纤维素溶液灌肠、白细胞去除疗法和粪便微生物群移植(FMT)等保守治疗,并结合饮食和生活方式支持来改善症状。本文就DC的发病机制、现状、临床特点、诊断策略及治疗进展进行综述,希望为DC的诊治提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Pathogenesis and progress in diagnosis and treatment of diversion colitis after colorectal cancer surgery].

Diversion colitis (DC) is a non-specific inflammation caused by the lack of fecal flow stimulation in the distal intestine after intestinal diversion surgery. It is mainly related to factors such as intestinal flora imbalance, deficiency of short-chain fatty acid (SCFA) and immune abnormalities. The clinical manifestations of diversion colitis include abdominal pain, mucus and bloody stools, diarrhea and other symptoms, but most patients may have no obvious symptoms. Diagnosis mainly relies on endoscopic examination and pathological characteristics. Common endoscopic findings include mucosal congestion, edema, and increased fragility, and the histological manifestation is mainly lymphoid follicle hyperplasia. Other intestinal inflammatory diseases need to be excluded. The treatment options include surgical and conservative medical therapies, among which stoma reversal is the most effective treatment to restore intestinal continuity. Conservative treatments such as SCFA, 5-aminosalicylic acid (5-ASA), steroid or cellulose solution enema, leukocyte removal therapy and fecal microbiota transplantation (FMT) can be used for those who cannot undergo surgery, combined with diet and lifestyle support to improve symptoms. This article summarized the pathogenesis, status, clinical features, diagnostic strategy and treatment progress of DC, hoping to provide reference for the diagnosis and treatment of DC.

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来源期刊
中华胃肠外科杂志
中华胃肠外科杂志 Medicine-Medicine (all)
CiteScore
1.00
自引率
0.00%
发文量
6776
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