创伤外科杂志
創傷外科雜誌
창상외과잡지
JOURNAL OF AUMATIC SURGERY
2015年
3期
193-196
,共4页
腹部损伤%开放疗法%损害控制
腹部損傷%開放療法%損害控製
복부손상%개방요법%손해공제
abdominal injury%open abdomen therapy%damage control
腹腔开放疗法是治疗严重腹部创伤患者的一项重要损害控制外科进展。腹腔开放疗法可用于腹部实质性脏器破裂特别是肝脏破裂使用纱布填塞法止血的患者、腹腔高压合并多脏器功能障碍和腹部创伤伴腹腔严重污染或严重感染患者。腹腔开放达到治疗目的后,应首先考虑尽早全层关腹。如二期全层关腹有困难,按阶段性治疗策略施行腹腔开放疗法,即将腹腔开放疗法分为早期开放、中期维持和后期腹壁重建阶段。腹腔开放疗法需要重点防治的并发症包括肠空气瘘和腹壁缺损。
腹腔開放療法是治療嚴重腹部創傷患者的一項重要損害控製外科進展。腹腔開放療法可用于腹部實質性髒器破裂特彆是肝髒破裂使用紗佈填塞法止血的患者、腹腔高壓閤併多髒器功能障礙和腹部創傷伴腹腔嚴重汙染或嚴重感染患者。腹腔開放達到治療目的後,應首先攷慮儘早全層關腹。如二期全層關腹有睏難,按階段性治療策略施行腹腔開放療法,即將腹腔開放療法分為早期開放、中期維持和後期腹壁重建階段。腹腔開放療法需要重點防治的併髮癥包括腸空氣瘺和腹壁缺損。
복강개방요법시치료엄중복부창상환자적일항중요손해공제외과진전。복강개방요법가용우복부실질성장기파렬특별시간장파렬사용사포전새법지혈적환자、복강고압합병다장기공능장애화복부창상반복강엄중오염혹엄중감염환자。복강개방체도치료목적후,응수선고필진조전층관복。여이기전층관복유곤난,안계단성치료책략시행복강개방요법,즉장복강개방요법분위조기개방、중기유지화후기복벽중건계단。복강개방요법수요중점방치적병발증포괄장공기루화복벽결손。
Open abdomen therapy is one of the most important damage control surgical procedures in the management of abdominal surgery. Open abdomen therapy can be used in severe hepatic injury complicated with massive bleeding,high intra-abdominal pressure with consequent multiple organs dysfunction and severe intra-ab-dominal infection after abdominal trauma.Abdomen could be closed by delayed facial closure after the bleeding or infection are controlled.The open abdomen could be managed by stages including early opening,maintaining and intestinal and abdominal wall reconstruction.Enteroatmospheric fistulae and abdominal defect are the two most fre-quent complications that should be prevented and treated.