State of the Art Review: Secondary peritonitis: principles of diagnosis and intervention
State of the Art Review: Secondary peritonitis: principles of diagnosis and intervention
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最先进的评论：继发性腹膜炎：诊断和干预原则
DOI：
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
H. Harris
中科院分区：
文献类型：
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作者：
James T. Ross;M. Matthay;H. Harris
摘要继发性腹膜炎占全球急诊或急诊住院患者的1%，是全球重症监护病房患者败血症的第二大原因。总体死亡率为6%，但严重脓毒症患者的死亡率上升至35%。尽管成像和实验室测试的可用性和使用有了显著的增长，但腹膜炎的快速诊断和早期处理仍然是急诊内科、外科和危重护理医生面临的挑战。在这篇文章中，我们回顾了腹膜炎的病理生理学及其向脓毒症的潜在进展，讨论了体检、实验室和放射学检查的效用和局限性，并提出了继发性腹膜炎的治疗范例。
ABSTRACT Secondary peritonitis accounts for 1% of urgent or emergent hospital admissions and is the second leading cause of sepsis in patients in intensive care units globally. Overall mortality is 6%, but mortality rises to 35% in patients who develop severe sepsis. Despite the dramatic growth in the availability and use of imaging and laboratory tests, the rapid diagnosis and early management of peritonitis remains a challenge for physicians in emergency medicine, surgery, and critical care. In this article, we review the pathophysiology of peritonitis and its potential progression to sepsis, discuss the utility and limitations of the physical examination and laboratory and radiographic tests, and present a paradigm for the management of secondary peritonitis.