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主管:陕西省卫生健康委员会
主办:西安心身医学研究所
   西安交通大学第一附属医院
国际标准刊号:ISSN2096—1413
国内统一刊号:CN61—1503/R

放射性肠炎的发病机制及其治疗进展

朱丽娜,武文辉,廖玮浩,党升强

陕西省西安市长安医院,陕西 西安,710100

浏览次数:88次 下载次数:294次

摘要:

放射性肠炎(RE)是放疗后常见的肠道并发症,可累及肠道任何节段,临床主要表现为腹痛、腹泻,严重者可发生肠梗阻、肠穿孔以及肠瘘等。本病病理变化特殊,处理困难,主要以预防为主。但对于已经发生 RE 者,目前主要治疗措施包括药物、高压氧等内科保守方法,缺乏统一的治疗策略。本研究就 RE 的发病机制、治疗进展作一综述,为 RE 的临床诊治提供一定参考。

关键词: 放射性肠炎(RE);药物;机制;高压氧;进展

中图分类号: R735.3文献标志码:A文章编号: 2096-1413(2018)07-0196-03

    The pathogenesis and progress of treatment of radiation enteritis


    ZHU Li-na,WU Wen-hui,LIAO Wei-hao,DANG Sheng-qiang
    (Changan Hospital of Xi`an City, Xi`an 710100, China)


    ABSTRACT: Radiation enteritis (RE) is a common intestinal complication after radiotherapy, and can affect any segment of the intestine.The main clinical manifestations were abdominal pain,diarrhea, and patients with severe illness can produce intestinal obstruction, intestinal perforation and intestinal fistula.The pathological changes of the disease are special,and the treatment is difficult. The main treatment measures include drug,hyperbaric oxygen and other conservative  methods of internal medicine for RE,but it is lack of unified strategy. This study makes a review of the pathogenesis and the progressin thetreatment of RE.It provides a reference for thediagnosis and treatment of RE.             

    KEYWORDS: radiation enteritis (RE); drug; mechanism; hyperbaric oxyen; progress

    参考文献:
    [1]KALAISELVAN R,THEIS VS,DIBB M,etal.Radiation enteritisleading to intestinalfailure:1994 patient-years ofexperience in a nationalreferralcentre[J].EurJClin Nutr,2014,68(2):166-170.
    [2]W IESENDANGER-W ITTMER EM,SIJTSEMA NM,MUIJS CT,etal.Systematic review ofthe role ofa belly board device in radiotherapydelivery in patients with pelvic malignancies[J].Radiother Oncol,2012,102(3):325-334.
    [3]LIU M,LIU B,W ANG H,etal.Dosimetric comparative study of3 different postoperative radiotherapy techniques (3DCRT,IMRT,andRapidArc) for  stage rectal cancer[J].Medicine (Baltimore),2015,94(1):e372.
    [4] 李宁 . 放射性肠炎的病程和外科治疗 [J]. 中国实用外科杂志 ,2004,24(7):385-389.
    [5] 沈历宗 , 华一兵 , 吴文溪 , 等 . 慢性放射性肠炎外科治疗探讨 [J]. 中国实用外科杂志 ,2004,24(8):491-492.
    [6] 管远志 . 肠道菌群及其生物学意义 [J]. 临床儿科杂志 ,2009,27(11):1095-1097.
    [7] CRAW FORD PA,GORDON JI.M icrobial regulation of intestinalradio sensitivity[J].Proc NatlAcad SciUSA,2005,102(37):13254-13259.
    [8] KATSANOS KH,BRIASOULIS E,TSEKERIS P,et al.Randomizedphase Ⅱ exploratory study ofprophylactic amifostine in cancerpatients who receive radicalradiotherapy to the pelvis[J].J Exp ClinCancerRes,2010,29(1):68.
    [9] CALOGLU M,CALOGLU VY,YALTA T,etal.The histopathologicalcomparison ofL-carnitine with amifostinefor protective efficacy onradiation-induced acute small intestinal toxicity[J].J Cancer ResTher,2012,8(2):260-265.
    [10]FUCCIO L,FRAZZONIL,GUIDO A,etal.Prevention ofpelvic radiation disease[J].W orld JGastrointestPharmacolTher,2015,6(1):1-9.
    [11] KOUKOURAKIS M I,KYRGIAS G,PANTELIADOU M,et al.Doseescalation ofamifostine forradioprotection during pelvic acceleratedradiotherapy[J].Am JClin Oncol,2013,36(4):338-343.
    [12] DEMERS M,DAGNAULT A,DESJARDINS J,et al.A randomizeddouble-blind controlled trial:impactofprobioticson diarrhea in patients treated with pelvic radiation[J].Clin Nutr,2014,33(5):761-767.
    [13] SPYROPOULOS BG,THEDOROPOULOS G,MISIAKOS EP,et al.The effectofsynbioticson acute radiation-induced diarrhea and itsassociation with mucosal inflammatory and adaptive responses inrats[J].DigDisSci,2013,58(9):2487-2498.
    [14]VISICH KL,YEO TP.The prophylactic use ofprobioticsin the preventionofradiation therapy-induced diarrhea[J].Clin J OncolNurs,2010,14(4):467-473.
    [15]HU C,SONG J,YOU Z,etal.Zinc oxide-montmorilionite hybrid influencesdiarrhea,intestinalmucosalintegrity,and digestive enzymeactivity in weaned pigs[J].BiolTrace Elem Res,2012,149(2):190-196.
    [16]HOVDENAK N,SORBYE H,DAHL O,etal.Sucralfate doesnotameliorate acute radiation proctitis:randomised study and meta-analysis[J].Clin Oncol(R CollRadiol),2005,17(6):485-491.
    [17]GIBSON RJ,KEEFE DM,LALLA RV,etal.Systematic review ofagentsforthe managementofgastrointestinalmucositisin cancerpatients[J].SupportCareCancer,2013,21(1):313-326.
    [18]BETTENHAUSEN D,MALIK U,SELLITTIE M,etal.Prevention ofacute radiation-induced proctosigmoiditis by balsalazide:Randomized,double-blind,placebo controlled trialin prostate cancer patients[J].IntJRadiatOncolBiolPhys,2015,63(5):1483-1487.
    [19]FUCCIO L,FRAZZONIL,GUIDO A,etal.Prevention ofpelvic radiation disease[J].W orld JGastrointestPharmacolTher,2015,6(1):1-9.
    [20] 冯敬霞 , 刘春梅 , 王淑安 , 等 . 放射性直肠炎的中医病因病机及治疗探讨 [J]. 四川中医 ,2009,27(2):38-39.
    [21] 武寒飞 , 洪智攀 , 丁健华 , 等 . 凉血愈肠汤对急性放射性肠炎的治疗及作用机制 [J]. 世界华人消化杂志 ,2012,20(13):1137-1141.
    [22] 姚诗清 , 周兰 , 陈莉 , 等 . 复方黄藤合剂治疗湿热蕴结证急性放射性肠炎 [J]. 中成药 ,2015,37(6):1201-1204.
    [23]LIGH,ZHANG YP,TANG JL,etal.Effectsofberberine againstradiation-induced intestinalinjury in mice[J].IntJ RadiatOncolBiolPhys,2010,77(5):1536-1544.
    [24] 罗淑红 , 袁征 , 陈晓婷 , 等 . 十灰散灌肠治疗急性放射性肠炎 28 例[J]. 河南中医 ,2014,6(8):119-122.
    [25] 付烊 , 田桢 , 乔占兵 , 等 . 槐绛方灌肠治疗急性放射性肠炎的临床研究 [J]. 中华中医药杂志 ,2015,10(10):41-44.
    [26] VIDAL -CASARIEGO A,CALLEJA -FEMANDEZ A,URBINA -GONZALEZ JJ,etal.Efficacyofglutaminein theprevention ofacuteradiation enteritis:a randomized controlled trial[J].JParenterEnteralNutr,2014,38(2):205-213.
    [27]TAHIR AR,W ESTHUYZEN J,DASS J,etal.Hyperbaric oxygen therapy for chronic radiation -induced tissue injuries: Australasia``slargeststudy[J].AsiaPacJClin Oncol,2015,11(1):68-77.
    [28]OUAISSIM ,TRAN S,MEGE D,etal.Pelvic radiation disease managementby hyperbaric oxygen therapy:Prospective study of44 patients[J].GastroenterolResPract,2014,(2014):108073
    [29]LATERZA L,CECINATO P,GUIDO A,etal.M anagementofradiation-induced rectal bleeding[J].Curr Gastroenterol Rep,2013,15(11):355.
    [30]VOSW INKEL J,FRANCOIS S,SIMON JM ,etal.Use ofmesenchymalstem cells(MSC)in chronicinflammatoryfistulizingand fibroticdiseases:a comprehensive review[J].Clin RevAllergyImmunol,2013,45(2):180-192.

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