中国普外基础与临床杂志

中国普外基础与临床杂志

损伤控制理论在腹腔脓毒症中的应用进展

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目的 总结损伤控制理论在腹腔脓毒症中的应用价值。 方法 以“腹腔脓毒症”“损伤控制复苏”“损伤控制外科”及“腹腔间隙综合征”为检索词检索文献,就损伤控制理论在腹腔脓毒症中的应用进展作一综述。 结果 虽然在管理和治疗方面取得了显著进步,但腹腔脓毒症的死亡率仍然很高。由于其独特的解剖和微生物环境,初步手术不能完全清除感染源,避免并发症。因此,采用简短初步手术和再次手术的损伤控制理念在腹腔脓毒症中得到推广应用。 结论 损伤控制理论以分阶段治疗为特点,临床上广泛认可采用损伤控制理念管理腹腔脓毒症。

Objective To explore the application value of damage control (DC) in intra-abdominal sepsis (IAS). Methods The related literatures were searched by searching literatures with" damage control”" damage control resuscitation”damage control surgery”, and" intra-abdominal sepsis”, to made an review. Results Despite significant advances in management and treatment, mortality from intra-abdominal sepsis remained still high. Due to its unique anatomic and microbial environment, initial operation could not completely remove the source of infection and avoid complications. Therefore, it was becoming increasingly popular to utilize a DC strategy with abbreviated laparotomy and planned reoperations. Conclusions DC is characterized by staged treatment, and is widely accepted used to manage intra-abdominal sepsis.

关键词: 腹腔脓毒症; 损伤控制复苏; 损伤控制外科; 腹腔间隙综合征; 综述

Key words: intra-abdominal sepsis; damage control resuscitation; damage control surgery; abdominal compartment syndrome; review

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