Exploratory laparotomy for potential abdominal sepsis in patients with multiple-organ failure.
Exploratory laparotomy for potential abdominal sepsis in patients with multiple-organ failure.
复制标题
剖腹探查术治疗多器官衰竭患者潜在的腹部脓毒症。
DOI：
10.1001/archsurg.1983.01390100004002
复制
发表时间：
1983
影响因子：
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通讯作者：
V. Ferraris
中科院分区：
文献类型：
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作者：
V. Ferraris
我们研究了29例多器官功能衰竭（MOF）患者，他们因怀疑腹腔内脓毒症而接受剖腹探查术。目的是确定持续性腹腔脓毒症的预测因素，并评估这些重症患者的手术结果。持续腹腔内脓毒症的最强预测因素是不明原因的单器官衰竭，发生在17例患者中。由于29例患者中只有15例有急性腹部检查结果，因此体格检查结果不是腹部脓毒症的完全可靠指标。无急腹症发现的患者脓毒症的主要线索是器官衰竭恶化。29例患者中有15例死于持续性MOF。只有一名50岁以上的患者存活。对某些器官功能衰竭的病人应尽早手术治疗。特别是积极的手术治疗似乎合理的年轻患者不明原因的单一器官衰竭或恶化的多器官功能衰竭。
We studied 29 patients with multiple-organ failure (MOF) who underwent exploratory laparotomy because of suspected intra-abdominal sepsis. The purpose was to identify predictors of continuing abdominal sepsis and to assess outcome of operation in these severely ill patients. The strongest predictor of continuing intra-abdominal sepsis was development of unexplained single-organ failure, which occurred in 17 patients. Physical findings were not a totally reliable indicator of abdominal sepsis since only 15 of 29 patients had acute abdominal findings. The main clue to sepsis in patients without acute abdominal findings was worsening organ failure. Fifteen of 29 patients died of continuing MOF. Only one patient older than 50 years survived. We suggest that earlier operation is indicated in certain patients with organ failure. Particularly aggressive operative therapy seems justified in young patients with unexplained single-organ failure or worsening MOF.