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[术后腹腔内并发症的诊断与治疗]

[Diagnosis and treatment of postoperative intraabdominal complications].

作者信息

Kriger A G, Shurkalin B K, Glushkov P S, Andreĭtsev I L

出版信息

Khirurgiia (Mosk). 2003(8):19-23.

Abstract

Postoperative complications after 8168 reoperations were seen in 143 (1.8%) patients. Clinical symptoms, laboratory tests, results of x-ray and ultrasound examinations were taken into account in diagnosis of the complications. Differential diagnosis of postoperative peritonitis, stable paralytic intestinal obstruction, early adhesive obstruction and intraabdominal bleeding based only on clinical data is difficult in many cases. Ultrasonic examination and laparoscopy permitted to reduce number of unjustified relaparotomies. In the majority of cases relaparotomy was considered as a method of choice in treatment of these complications. Mini-invasive surgeries may be performed only in mild complications. Lethality in the treatment of postoperative complications after relaparotomy was 39.4%, after laparoscopic surgeries--8.8%, after US-assisted drainage--0. General lethality was 29.4%.

摘要

8168例再次手术患者中有143例(1.8%)出现术后并发症。并发症的诊断考虑了临床症状、实验室检查、X线和超声检查结果。在许多情况下,仅根据临床资料对术后腹膜炎、稳定型麻痹性肠梗阻、早期粘连性肠梗阻和腹腔内出血进行鉴别诊断是困难的。超声检查和腹腔镜检查减少了不必要的再次剖腹手术次数。在大多数情况下,再次剖腹手术被认为是治疗这些并发症的首选方法。微创外科手术仅适用于轻度并发症。再次剖腹手术后治疗术后并发症的死亡率为39.4%,腹腔镜手术后为8.8%,超声引导下引流后为0。总死亡率为29.4%。

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