术后腹膜炎的外科治疗方法

I. Shevchuk, M. Droniak, V. Droniak
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引用次数: 0

摘要

目标。为提高术后腹膜炎患者的手术治疗效果,提出了一定的算法。材料和方法。前瞻性调查244例术后腹膜炎患者(主组)。根据腹膜影响大小,术后局限性腹膜炎125例(51.2%),延伸性腹膜炎119例(48.8%)。回顾性研究212例术后腹膜炎患者(对照组)。结果。114例(46.7%)术后腹膜炎患者行微创手术再干预治疗,其中55例(48.2%)采用腹腔镜清理腹腔脓肿引流术。34例环间脓肿术后腹膜炎19例(55.9%)行腹腔镜脓肿清理引流术。130例(53.3%)患者接受开放手术干预。结论。术后腹膜炎手术治疗细化算法的应用使患者卧床时间由(14.2±1.6)个床日(对照组)减少到(10.6±1.2)个床日(主组),病死率由31.6%(对照组)降低到18.4%(主组)。
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Algorithm of surgical treatment of postoperative peritonitis
Objective. To improve the results of surgical treatment in patients with postoperative peritonitis, using the certain algorithm proposed. Materials and methods. Prospective investigation was conducted on 244 patients, suffering postoperative peritonitis (the main group). In accordance to the peritoneal affection size the restricted postoperative peritonitis was present in 125 (51.2%) patients, and the extended one – in 119 (48.8%). Retrospective investigation consisted of studying of 212 cards of stationary patients, operated for postoperative peritonitis (the control group). Results. Miniinvasive operative reinterventions were done in 114 (46.7%) patients, suffering postoperative peritonitis, of them in 55 (48.2%) laparoscopic sanation and drainage of the peritoneal cavity abscess was used. In 19 (55.9%) of 34 patients with postoperative peritonitis in the interloop abscesses a laparoscopic sanation and drainage of the abscess were performed. Open operative interventions were performed in 130 (53.3%) patients. Conclusion. Application of the elaborated algorithm of the postoperative peritonitis surgical treatment have permitted to reduce the patients stationary stay from (14.2 ± 1.6) bed–days (control group) to (10.6 ± 1.2) bed–days (main group) and to reduce the lethality level from 31.6% (control group) to 18.4% (the main group).
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