穿孔性消化性溃疡胃手术修补术后的介入性重症监护:病例报告

Liliriawati Ananta Kahar
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引用次数: 0

摘要

导言:消化性溃疡穿孔是急诊胃部手术最常见的指征。在重症监护病房对消化性溃疡穿孔患者进行良好的术后管理将降低患者的死亡率。病例介绍 一位 76 岁的男性患者以全腹疼痛为主诉,入院 1 天后疼痛加剧,入院前腹痛已持续 4 天。患者有 3 年常规服用止痛药的病史。患者生命体征正常,qSOFA评分1分,VAS评分5分。腹部体格检查显示腹部胀满,无明显轮廓,无明显蠕动,肠鸣音减弱,全腹有压痛和反跳痛 患者被送入急诊腹腔镜手术室,随后患者在择期环境下接受了诊断性腹腔镜手术,术中发现胃穿孔,随后患者继续进行胃修补术。术后,患者在 M. Djamil 医生综合医院重症监护室接受治疗。结论胃修补术后患者的重症监护管理一般与其他腹部手术患者相同。重症监护管理需要从氧疗、监测、镇痛、液体治疗、抗生素治疗、血糖控制和鼻胃管营养等方面入手,进行综合治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Interventional Intensive Care in Postoperative Period of Gastric Surgical Repair Due to Perforated Peptic Ulcer Disease : A Case Report
Introduction: Perforated peptic ulcer is the most common indication for emergency gastric surgery. good management of postoperative peptic ulcer perforation patients in the ICU will reduce patient mortality rates. Case presentation A 76-year-old male patient presented with a major complaint of pain throughout the abdomen that had worsened since 1 day, the abdominal pain had been felt for 4 days before admission. The patient had a history of painkiller drug consumption routinely for 3 years. The patient’s vital signs were normal, with a qSOFA score 1 and a VAS score 5. Abdominal physical examination showed the abdominal distended, no visible contour and no visible peristaltic, decreased bowel sound, and there is tenderness and rebound tenderness at the whole abdomen Patient was taken up for emergency laparostomy, then the patient underwent diagnostic laparoscopic in an elective setting with intraoperative findings of gastric perforation, then patient continued with the gastric repair. In the postoperative period, the patient was treated in the ICU of Dr. M. Djamil General Hospital. Conclusion: Intensive care management for post-gastric repair surgery patients is generally the same as for other abdominal surgery patients. The intensive care management needs comprehensive treatment, starting from oxygen therapy, monitoring, analgesia, fluid therapy, antibiotic therapy, glycemic control, and nasogastric tube nutrition.
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