小肠梗阻的综合诊治现状：影像学诊断、血清标志物与治疗策略
Current Diagnosis and Treatment of Small Bowel Obstruction: Imaging Diagnosis, Serum Biomarkers, and Treatment Strategies
摘要: 小肠梗阻(SBO)是临床常见的急腹症，若未能及时诊断和处理，可能引发严重并发症，甚至死亡。特别是在老年患者中，由于生理机能下降，肠坏死的发生率较高。本文回顾了小肠梗阻的诊断方法、影像学检查及治疗进展，重点讨论了CT、X线、超声和MRI等影像学手段在诊断中的应用，特别是如何通过影像学特征预测肠缺血和坏死。此外，文章还探讨了生物标志物(如乳酸、D-二聚体、PCT和I-FABP)在肠缺血诊断中的潜力。手术治疗和保守治疗的适应症及决策依据也得到了详细分析。尽管现有诊疗方案已取得一定成效，但对于早期肠绞窄和缺血的识别仍存在挑战，未来需要更多多中心研究优化诊断和治疗策略。
Abstract: Small bowel obstruction (SBO) is a common acute abdominal condition, which, if not diagnosed and managed promptly, may lead to severe complications, including death. This risk is particularly higher in elderly patients due to diminished physiological function and increased likelihood of bowel necrosis. This review discusses the diagnostic methods, imaging techniques, and therapeutic advances in SBO, with a focus on the use of CT, X-ray, ultrasound, and MRI in diagnosis, particularly in predicting bowel ischemia and necrosis through imaging features. Furthermore, the potential of serum biomarkers such as lactate, D-dimer, procalcitonin (PCT), and intestinal fatty acid-binding protein (I-FABP) in diagnosing bowel ischemia is explored. The indications for and decision-making processes surrounding both surgical and conservative treatments are also analyzed. While current diagnosis and treatment strategies have shown effectiveness, early identification of bowel strangulation and ischemia remains a challenge, highlighting the need for more multicenter studies to optimize diagnosis and treatment strategies.
文章引用：蔡丞俊, 马冰清, 张进祥. 小肠梗阻的综合诊治现状：影像学诊断、血清标志物与治疗策略[J]. 临床医学进展, 2025, 15(4): 97-106. https://doi.org/10.12677/acm.2025.154906

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