Curso clínico de la peritonitis grave en pacientes críticamente enfermos tratados con sutura primaria diferida
Curso clínico de la peritonitis grave en pacientes críticamente enfermos tratados con sutura primaria diferida
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严重腹膜炎临床临床与原发性腹膜炎的临床治疗
DOI：
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发表时间：
2008
期刊：
影响因子：
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通讯作者：
Marisol Badiel
中科院分区：
文献类型：
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作者：
C. A. Ordóñez;J. A. Pineda;R. Arias;F. Benítez;L. E. Toro;G. Aristizábal;J. Martínez;F. Rosso;Marcela Granados;Marisol Badiel
导论.一期吻合术是治疗重症患者严重继发性腹膜炎的可行技术;然而，由于并发症和死亡风险，其使用受到限制。材料和方法。我们选择了患有严重继发性腹膜炎的患者，这些患者需要切除肠段，并采用临时肠结扎、开腹、择期重复剖腹术和进一步延迟的初次吻合术进行治疗。在初次吻合且无渗漏或瘘的患者中标记为初始成功。结果26名患者被纳入研究，平均APACHE II评分为15.3。小肠6例，大肠5例，回肠至大肠4例，3例患者无法进行吻合。从吻合术后24小时开始，平均登记了4例计划再次剖腹术。20例患者（77%）取得了初步成功，28天生存率为88.3%; 23例患者存活出院，仅3例（11.5%）在ICU死亡;这些死亡与手术无关。讨论损伤控制手术在严重继发性腹膜炎患者中是可行和安全的，初次成功率为77%;瘘发生率为11.5%，死亡率为11.5%。
Introduction. Primary anastomosis is a feasible technique in the management of severe secondary peritonitis in critically ill patients; however, its use has been limited due to the risk of complications and death. Materials and methods. We selected patients with severe secondary peritonitis that required resection of an intestinal segment and managed with temporary intestinal ligature, open abdomen, elective repeat laparotomies, and ulterior deferred primary anastomosis. Primordial success was labeled in those patients that had primary anastomosis and no leakage or fistulae. Results. Twenty six patients were included in the study, with a mean APACHE II score of 15.3. There were 6 anastomoses in the small bowel, 5 in the large bowel, 4 of the ileum to the large bowel, and in 3 patients an anastomosis could not be performed. A mean of 4 scheduled relaparotomies were registered, starting 24 hours after the anastomosis. Primordial success was achieved in 20 patients (77%), 28-day survival was 88.3%; 23 patients left the hospital alive, and only 3 (11.5%) died in the ICU; these deaths were independent of the procedure. Discussion. Damage control surgery was feasible and secure in patients with severe secondary peritonitis, with a primary success rate of 77%; fistulae developed in 11.5%, and mortality was 11.5%.
重症监护室患者持续性腹膜炎的微生物学特征和治疗。
DOI：
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发表时间：
1986
期刊：
Canadian journal of surgery. Journal canadien de chirurgie
影响因子：
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作者：
Rotstein,OD;Pruett,TL;Simmons,RL
通讯作者：
Simmons,RL