1、A 43 year old female presents to the ED with cc of “burning pain” in her abdomen for one month. She notes the pain is intermittent, not-positional, worst 3 hours after a meal, and is mitigated immediately after a meal. Her pain is worse at night (particularly between 11 pm and 2 am) and prevents her
2、 from “sleeping well”. She also notes mild nausea, no vomiting. Her BMs are daily and “normal.” She sees no blood / melana PR.,概述(Introduction),第一节 胃肠动力障碍 Gastrointestinal motor disorders,容受性舒张 咀嚼、吞咽咽、食管迷走N 的抑制性纤维胃平滑肌舒张 意义:容纳、暂时贮存食物,胃的蠕动,分节运动,胃肠动力障碍 各种病因引起原发或继发性胃肠神经,体液及肌细胞受损后使胃肠道平滑肌细胞运动功能发生障碍的病理过程。 可表现为:运动加快和减缓,2、神经源性因素,ENS(肠神经系统),enteric nervous system 由肌间神经丛和黏膜下神经丛组成。含有大量的感觉、整合和运动神经元,胃轻瘫,第二节 吸收不良 Malabsorption,二、发病机制,1. 消化不良 ()胰腺功能障碍,第三节 屏障功能障碍 Gut Barrier Dysfunction,(2)内毒素血症,