负压装置用于腹部有敌意的儿科患者。病例系列。

K Serrano Concha, H Morales Mayorga, D Acosta Farina, L Mendoza Saldarreaga, V Pólit Guerrero, J Oliveros Rivero, D Acosta Bowen
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引用次数: 0

摘要

简介敌对腹部是一种外科病症,其特点是腹部器官和结构之间失去空间。负压疗法在成人中应用广泛,但在儿科患者中的应用却不尽相同。本研究的目的是介绍因不同病因导致腹部受压的儿科患者使用负压疗法的短期效果:对使用 ABTHERA 负压疗法治疗的小儿腹部窘迫症患者(小于 18 岁)进行识别和回顾性审查:本研究共纳入 7 名患者。中位年龄为 16 岁(9-17 岁)。5例(71.4%)为男性,2例(28.6%)为女性。3人(43%)既往有严重的内外科病史(系统性红斑狼疮、复杂的阑尾切除术和脑室腹腔分流术)。设备的持续压力设定为-50至-125毫米汞柱。手术前和手术后的检查结果采用比约克分类法进行报告。设备每 4-7 天更换一次(中位数为 5 天)。总更换次数为 1-4 次(中位数为 3 次)。根据临床状况,5 名(71.4%)患者在使用负压疗法期间需要进行有创机械通气。4名患者(57%)接受了肠内营养。1(14%)名患者因腹膜后脓肿发展而需要在最终闭合后再次介入治疗。根据(口服耐受性、肠蠕动和无痛)评估,所有患者的治疗效果都很好:结论:负压治疗设备对小儿腹部敌意效果良好,但还需要进一步的信息来评估压力设置和设备更换频率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Negative pressure device used in pediatric patients with Hostile abdomen. Case series.

Introduction: Hostile abdomen is a surgical condition characterized by loss of space between organs and structures in the abdomen. Negative pressure therapy use has been widely described in adults; the case is not the same for pediatric patients. The goal of this study is to present short-term results of negative pressure therapy use in pediatric patients with hostile abdomen due to different etiologies.

Material and methods: Pediatric hostile abdomen patients (< 18 years) who were treated Negative pressure therapy using ABTHERA were identified and retrospectively reviewed.

Results: 7 patients were included in this study. Median age was 16 (range: 9-17 yo). 5 (71.4%) were male and 2 (28.6%) females. 3 (43%) had significant past medical/surgical history (Systemic Lupus Erythematosus, complicated appendectomy and ventriculoperitoneal-shunt). The device was set at a continuous pressure ranging from -50 to -125 mmHg. Pre and post-surgical findings were reported using Bjork's classification. Devices were replaced every 4-7 days (median 5 days). Total amount of replacements was 1-4 (median 3). 5 (71.4%) patients required invasive mechanical ventilation during use of Negative pressure therapy based on clinical status. 4 (57%) patients received enteral nutrition. 1 (14%) patient required re-intervention posterior to definitive closure due to retroperitoneal abscess development. Outcome, evaluated by (oral tolerance, bowel movement and absence of pain), was favorable in all patients.

Conclusion: Negative pressure therapy devices generate favorable results in hostile abdomen in pediatric population but further information is needed to assess pressure settings and device replacement frequency.

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