恶性肠梗阻患者的代谢紊乱

doi:10.16689/j.cnki.cn11-9349/r.2020.03.004

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摘要恶性肠梗阻是由恶性肿瘤引起的小肠或大肠梗阻，常见于卵巢癌及胃肠道肿瘤患者。恶性肠梗阻是由于肿瘤压迫、肿瘤细胞浸润自主神经、副肿瘤综合征或药物因素导致的急性或慢性肠道梗阻，是晚期肿瘤患者常见的致死性并发症之一。本文综合国内外进展探讨恶性肠梗阻患者的代谢紊乱情况及其机制，得出以下提示:恶性肠梗阻不仅引起葡萄糖、蛋白质、脂肪酸等宏量营养素的代谢紊乱，还会引起微量营养素代谢异常等。造成代谢紊乱的机制主要有肠道功能紊乱，肠道局部甚至全身发生炎性反应，肠道菌群紊乱及缺乏有效的营养治疗等因素。恶性肠梗阻患者发生代谢紊乱可能加剧肠梗阻的发展，更与患者的预后显著相关。临床决策中医生应重视患者的代谢情况，认识到代谢紊乱对恶性肠梗阻患者预后的影响，积极纠正代谢紊乱，提高患者的预后及生活质量。

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	罗贵娟
	缪明永

Abstract：Malignant bowel obstruction is malignant tumor associated intestinal obstruction common in patients with advanced ovarian cancer or gastrointestinal cancer. It’s one of the most lethal complications caused by tumor compression, tumor cell infiltration of autonomic nerves, paraneoplastic syndrome, or drug related factors. In this review, we delineate the current studies on metabolic disorders and mechanisms of malignant bowel obstruction at home and abroad and draw the following conclusions. Malignant bowel obstruction not only causes metabolic disorders of macronutrients such as glucose, protein, and fatty acids, but also causes micronutrients disorders. Intestinal dysfunction, inflammation and intestinal flora disorders, and lack of effective nutrition support contribute to the occurrence of malignant bowel obstruction. Metabolic disorders could aggravate obstruction and closely related to the prognosis. Clinical decision-making should pay attention to the metabolic situation. Recognizing the significant influence on the prognosis of patients, doctors should take active treatment to the metabolic disorder and improve quality of life.

Key words： Malignant bowel obstruction｜Macronutrients metabolic disorders｜Micronutrients metabolic disorders｜Inflammation｜Intestinal flora disorders Nutritional support

通讯作者: 缪明永，电子邮箱：miaomy@163.com

引用本文:

罗贵娟，缪明永. 恶性肠梗阻患者的代谢紊乱[J]. 肿瘤代谢与营养电子杂志, 2020, 7(3): 267-271.
Luo Guijuan, Miao Mingyong. Metabolic disorder in MBO. Electron J Metab Nutr Cancer, 2020, 7(3): 267-271.

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