Kostiuchenko K V
Vestn Khir Im I I Grek. 2004;163(3):40-3.
During 13 years 575 patients with various forms of generalized peritonitis were operated upon. The strategy of surgical treatment was determined depending on the kind of inflammation and the initial state of the patient. Mortality in semi-closed and semi-open strategy was 10.1% and 25.9% respectively. Mortality in cases with surgical complications after primary semi-closed strategy was 46.3% and the diagnostic time before the second operation was about 150 hours. An attempt to determine the prognosis of the development of complications and to work out recommendations on the strategy were made on the basis of the concept of the abdominal sepsis and using the APACHE II scoring system & Mannheimer Peritonitis-Index. The semi-open strategy was more preferable in the scores of APACHE II less than 11. The most effective method of intestinal decompression in suppurative peritonitis is total naso-intestinal decompression resulting in 29% less mortality.
在13年期间，对575例患有各种形式弥漫性腹膜炎的患者进行了手术。手术治疗策略根据炎症类型和患者的初始状态来确定。半封闭和半开放策略的死亡率分别为10.1%和25.9%。初次采用半封闭策略后出现手术并发症的病例死亡率为46.3%，二次手术前的诊断时间约为150小时。基于腹腔脓毒症的概念并使用急性生理与慢性健康状况评分系统（APACHE II）和曼海姆腹膜炎指数，尝试确定并发症发生的预后并制定有关策略的建议。急性生理与慢性健康状况评分系统（APACHE II）得分低于11分时，半开放策略更为可取。化脓性腹膜炎最有效的肠道减压方法是全鼻肠减压，可使死亡率降低29%。
