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岭南现代临床外科 ›› 2025, Vol. 25 ›› Issue (01): 1-5.DOI: 10.3969/j.issn.1009-976X.2025.01.001

• 论著与临床研究 •    下一篇

附加回肠造口的腹腔清创引流术治疗腹腔间隔室综合征

叶义标1, 徐云修修1, 陈捷1, 宋景林1, 彭林辉1, 周锐1, 姚婷婷2, 钟国平1, 凌小娟1, 罗兴喜1, 张贺云1, 徐鋆耀1, 叶华1, 陈亚进1, 王捷1, 陈涛1,*   

  1. 1.中山大学孙逸仙纪念医院肝胆胰外科,广州 510289;
    2.中山大学孙逸仙纪念医院妇产科,广州 510120
  • 通讯作者: *陈涛,Email:chentao@mail.sysu.edu.cn
  • 基金资助:
    广东省自然科学基金(2020A1515010944)

ILEOSTOMY for abdominal compartment syndrome

YE Yi-biao1, XU Yun-xiu-xiu1, CHEN Jie1, SONG Jing-lin1, PENG Lin-hui1, ZHOU Rui1, YAO Ting-ting2, ZHONG Guo-ping1, LING Xiao-juan1, LUO Xing-xi1, ZHANG He-yun1, XU Yun-yao1, YE Hua1, CHEN Ya-jin1, WANG Jie1, CHEN Tao1   

  1. 1. Department of General Surgery, Sun Yat-sen memorial hospital, Sun Yat-sen University, Yanjiang road west 107,Guanghzhou 510120, China;
    2. Department of Obstacles and Gynecology, Sun Yat-sen memorial hospital, Sun Yat-sen University, Yanjiang road west 107, Guanghzhou 510120, China
  • Received:2024-12-19 Online:2025-02-20 Published:2025-04-09
  • Contact: CHEN Tao, chentao@mail.sysu.edu.cn

摘要: 目的 探讨腹腔间隔室综合征(ACS)患者的诊治新方法。方法 回顾研究本院2017年5月至2022年3月收治的15例ACS, 包括重症急性胰腺炎6例、胰腺外伤2例、腹部疾病术后外科并发症7例。治疗包括采用了常规药物治疗及手术治疗,其中手术治疗除了采用一般常规方法以外,均附加了回肠造口术。诊治过程中通过观察腹腔压力、尿量、生存情况等预后因素,判断治疗效果。结果 多数患者(13/15,86.67%)治疗后腹腔压力明显改善。3例重症急性胰腺炎患者术前已经出现MOF,出现死亡情况,其余治愈患者治疗后所有生存指标明显改善、顺利康复。结论 采用常规保守治疗的基础上对于腹腔内炎症明显,肠道水肿、粘连严重患者附加回肠造口术可明显控制腹腔压力,及时阻断恶性循环,提高ACS患者救治成功率。附加常规回肠造口术有可能成为ACS患者重要的干预措施。

关键词: 腹腔间隔室综合征, 并发症, 回顾性研究, 预后, 回肠造口

Abstract: Objective To investigate new treatment method “ILEOSTOMY” for abdominal compartment syndrome (ACS). Methods Retrospectively reviewed clinical data of patients with ACS from May, 2017 through to March, 2022 admitted in Department General Surgery, and Department of Obstacles and Gynecology, Sun Yat-sen memorial hospital, Sun Yat-sen University. Patients included 6 cases of SAP(severe acute pancreatitis, SAP), 2 cases of pancreas trauma, and 7 cases of abdominal or pelvic surgical complications. All patients received routine treatment plus with “ILEOSTOMY” aimed for quickly decreasing the Intra-abdominal Hypertension (IAH). Clinical data of Intra-abdominal pressure (IAP), urine output, heart rate, breath rate and survival were collected and analyzed. Results IAH in most patients (13/15, 86.67%) were adjusted to normal level soon postoperatively. Twelve cases survived while other 3 cases who suffered MOF (Multiple Organ Failure, MOF) or MODS(multiple organ dysfunction syndrome, MODS) dead postoperatively. Conclusion “ILEOSTOMY” along with routinely suggested operation modality for selected ACS patient might be a good choice. More clinical data should be needed in the future.

Key words: abdominal compartment syndrome, ileostomy, treatment

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