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纤维蛋白封闭剂可预防腹腔内脓毒症时的胃肠吻合口裂开。

Fibrin sealant prevents gastrointestinal anastomosis dehiscence in intra-abdominal sepsis.

作者信息

Wang Xinbo, Ren Jianan, Zhu Weiming, Li Ning, Li Jieshou

机构信息

Research Institute of General Surgery, Jingling Hospital, Nanjing, China.

出版信息

Int Surg. 2007 Jan-Feb;92(1):27-31.

Abstract

We observed the potential use of fibrin sealant as a therapeutic modality for successful resolution of gastrointestinal anastomosis dehiscence in intra-abdominal sepsis. Forty-eight patients (33 men and 15 women) suffering from intra-abdominal sepsis were subjected to prophylactic appliance of fibrin sealant during immediate primary anastomosis during the laparotomy. The perioperative management invariably involved fluid resuscitation, active suction drainage of the abdominal liquor puris, nutritional supplementation, and growth hormone. The total surgical-related success ratio was 91.7% (44/48) for primary anastomosis with fibrin sealant in intra-abdominal sepsis. Anastomotic leakage occurred in the other four patients, two of which died because of leakage complications in our hospital. The hospital stay after the operation was 30.2 +/- 12.0 days. There has been no sign of recurrence over a follow-up period of 1-15 months. It is concluded that fibrin sealant may be useful in preventing gastrointestinal anastomosis dehiscence in intra-abdominal sepsis.

摘要

我们观察了纤维蛋白封闭剂作为一种治疗方式在成功解决腹腔内脓毒症中胃肠道吻合口裂开问题的潜在用途。48例腹腔内脓毒症患者(33例男性和15例女性)在剖腹手术进行一期吻合时接受了纤维蛋白封闭剂的预防性应用。围手术期管理始终包括液体复苏、积极抽吸腹腔脓性液体、营养补充和生长激素。在腹腔内脓毒症患者中,使用纤维蛋白封闭剂进行一期吻合的总手术相关成功率为91.7%(44/48)。其他4例患者发生吻合口漏,其中2例在我院因漏出并发症死亡。术后住院时间为30.2±12.0天。在1至15个月的随访期内没有复发迹象。结论是纤维蛋白封闭剂可能有助于预防腹腔内脓毒症中的胃肠道吻合口裂开。

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