创伤外科杂志
創傷外科雜誌
창상외과잡지
JOURNAL OF AUMATIC SURGERY
2014年
3期
193-196
,共4页
腹部创伤%感染%手术%预防
腹部創傷%感染%手術%預防
복부창상%감염%수술%예방
abdominal wounds%infections%surgery%prevention
感染并发症是腹部创伤患者后期主要死因,感染预防是提高生存率的关键之一。措施包括:早期诊断腹部创伤,及时手术以减少腹腔污染;手术操作规范化和按器官损伤分级正确选择手术方式;避免术中漏诊并对胃肠严重挫伤做预防性手术;彻底冲洗腹腔并合理使用腹腔引流;正确掌握损害控制外科技术如腹腔开放时的暂时重建屏障,填塞物的适时移除和尽早行确定性手术;全身和局部预防性抗生素的使用。同时重视预防休克后肠道内源性感染,要点包括正确实施“损害控制性复苏”以避免器官长时低灌流;尽早肠内营养;预防性使用抗生素。
感染併髮癥是腹部創傷患者後期主要死因,感染預防是提高生存率的關鍵之一。措施包括:早期診斷腹部創傷,及時手術以減少腹腔汙染;手術操作規範化和按器官損傷分級正確選擇手術方式;避免術中漏診併對胃腸嚴重挫傷做預防性手術;徹底遲洗腹腔併閤理使用腹腔引流;正確掌握損害控製外科技術如腹腔開放時的暫時重建屏障,填塞物的適時移除和儘早行確定性手術;全身和跼部預防性抗生素的使用。同時重視預防休剋後腸道內源性感染,要點包括正確實施“損害控製性複囌”以避免器官長時低灌流;儘早腸內營養;預防性使用抗生素。
감염병발증시복부창상환자후기주요사인,감염예방시제고생존솔적관건지일。조시포괄:조기진단복부창상,급시수술이감소복강오염;수술조작규범화화안기관손상분급정학선택수술방식;피면술중루진병대위장엄중좌상주예방성수술;철저충세복강병합리사용복강인류;정학장악손해공제외과기술여복강개방시적잠시중건병장,전새물적괄시이제화진조행학정성수술;전신화국부예방성항생소적사용。동시중시예방휴극후장도내원성감염,요점포괄정학실시“손해공제성복소”이피면기관장시저관류;진조장내영양;예방성사용항생소。
Posttraumatic intra-abdominal infections are the main cause for abdominal trauma patients mor-tality at late stage.Prevention of these complications is the key to increase the survival .The measures are as fol-lows:conducting early diagnosis and timely surgical intervention to shorten intra -abdominal contamination;standardi-zing surgical technique and appropriately selecting surgical procedure according to the classification of organ injury ;avoiding miss-diagnosis and performing preventive surgical procedure for severe gastrointestinal contusion during ini -tial laparotomy;thoroughly irrigating abdominal cavity;reasonably using drainage;correctly performing damage con-trol surgeries including temporary reconstruction while open abdomen being done ,removal of packing and timely per-formance of definitive procedure;and applying prophylactic systemic and topical antimicrobials .Besides,special at-tention should be given to the gut-origin infection following hemorrhagic shock .Preventive measures include correct-ly performing damage control resuscitation to avoid prolonged hypo-perfusion of organs ,conducting early enteral nu-trition and applying prophylactic antimicrobials .