Cuesta M A, Doblas M, Castañeda L, Bengoechea E
Department of Surgery, Hospital Virgen de la Salud, Toledo, Spain.
World J Surg. 1991 Jan-Feb;15(1):74-80. doi: 10.1007/BF01658968.
Frequently, several multiple abdominal reexplorations are needed in patients with acute necrotizing hemorrhagic pancreatitis (ANP) or with persistent intraabdominal sepsis (PIAS). Residual undrained necrotic and septic foci lead to multiple organ failure. To provide wide-open drainage of the abdominal cavity, since 1985 we have performed sequential abdominal reexploration with the zipper technique (SARZT) in 24 patients. Apache II score was used to evaluate expected mortality. In the pancreatic necrosis group, with a mean Apache II score of 31, the expected and the observed mortality were 70% and 29%, respectively. In the PIAS group, with a mean Apache II score of 30, the expected and observed mortality were 60 and 28%, respectively. These results are attributed to the sequential reexploration of the abdominal cavity that permits excision and drainage of necrotic and septic foci.
对于急性坏死性出血性胰腺炎（ANP）或持续性腹腔内脓毒症（PIAS）患者，通常需要多次进行腹部再次探查。残留的未引流坏死灶和感染灶会导致多器官功能衰竭。为实现腹腔的充分开放引流，自1985年以来，我们采用拉链技术对24例患者进行了序贯性腹部再次探查（SARZT）。使用急性生理与慢性健康状况评分系统II（Apache II）来评估预期死亡率。在胰腺坏死组中，Apache II评分平均为31分，预期死亡率和实际观察到的死亡率分别为70%和29%。在PIAS组中，Apache II评分平均为30分，预期死亡率和实际观察到的死亡率分别为60%和28%。这些结果归因于对腹腔的序贯性再次探查，它能够切除坏死灶和感染灶并进行引流。
