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[开放性腹部的晚期并发症]

[Late complications of open abdomen].

作者信息

Eder F, Tautenhahn J, Lippert H

机构信息

Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Medizinische Fakultät, Otto-von-Guericke-Universität, Leipziger Strasse 44, 39120 , Magdeburg.

出版信息

Chirurg. 2006 Jul;77(7):602-9. doi: 10.1007/s00104-006-1196-1.

Abstract

Open abdomen is the final result of a variety of diseases and their treatment strategies. The aim of this article is to present systematically late complications after open abdominal therapy and our own treatment results from 2003 to 2005. The main diagnoses for open abdomen are persistent peritonitis, abdominal compartment syndrome, and abdominal injuries. A perioperative mortality rate of 10-56%, long stays at the ICU, and a mean of 3-5 reoperations are characteristic for the severity of such diseases. Late complications may include incisional hernia (47-78%), gastrointestinal and pancreatic fistulas (8-41%), postoperative delayed abscess (10-21%), polyneuropathy (21%), psychic disorders (24%), indigestion (12%), and ossification (17%). These postoperative disorders may range in severity from clinically less significant to therapy-relevant with surgical consequences. Despite the high morbidity, approximately 75% of surviving patients achieve good quality of life. In our opinion, this justifies the extensive treatment concepts and associated high costs.

摘要

开放腹腔是多种疾病及其治疗策略的最终结果。本文旨在系统地介绍开放腹腔治疗后的晚期并发症以及我们2003年至2005年的治疗结果。开放腹腔的主要诊断包括持续性腹膜炎、腹腔间隔室综合征和腹部损伤。此类疾病的严重程度表现为围手术期死亡率为10% - 56%、在重症监护病房长时间停留以及平均3 - 5次再次手术。晚期并发症可能包括切口疝(47% - 78%)、胃肠道和胰瘘(8% - 41%)、术后延迟性脓肿(10% - 21%)、多发性神经病(21%)、精神障碍(24%)、消化不良(12%)和骨化(17%)。这些术后疾病的严重程度范围从临床上不太显著到与治疗相关并产生手术后果。尽管发病率很高,但约75%的存活患者生活质量良好。我们认为,这证明了广泛的治疗理念及相关的高昂费用是合理的。

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