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创伤后MOF的发生有3种学说:（1）介质学说;（2）缺血/再灌注学说;（3）肠道学说,三者最终均导致肠道屏障功能的丧失。（-）肠道的作用 在30％以上死于MOF的菌血症病人可无脓毒性病灶,肠道可能是全身菌血症或内毒素血症的致病源,因为肠道内的细菌和内毒素可进入全身血循环,1966年Wolochow更提出细菌移位的名称。肠源性感染的意义越来越得到临床上各方的关注,口服抗生素选择性去肠道污染可以降低免疫抑制病人的肠源性菌血症的发生率,并已证实咽喉局部抗生素的应用可以减少原发性菌血症以及呼吸道、泌尿道和伤口感染,肠道内细菌和内毒素引起全身感染或激发脓毒性状态,与MOF的发生关系已受到公认。
There are three theories about the occurrence of MOF after trauma: (1) the theory of media; (2) the theory of ischemia / reperfusion; (3) the gut theory that all three eventually lead to the loss of intestinal barrier function. (-) Effect of Intestinal There is no sepsis in patients with bacteremia that has died of MOF in more than 30% of the intestinal tract. The intestinal tract may be the causative agent of systemic bacteremia or endotoxemia because the gut bacteria and internal Toxins can enter the systemic circulation, and in 1966 Wolochow even proposed the name of bacterial translocation. The significance of gut infection is getting more and more attention in clinic. The selective detoxification of oral antibiotics can reduce the incidence of enteric bacteremia in immunosuppressed patients and the application of topical antibiotics in throat can be confirmed Reduce the incidence of primary bacteremia and respiratory tract, urinary tract and wound infections, intestinal bacteria and endotoxin cause systemic infection or stimulate septic state, and the occurrence of MOF has been recognized.