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[腹主动脉及外周动脉重建手术化脓性败血症并发症的预防与治疗]

[Prophylaxis and treatment of purulent-septic complications of reconstructive operations on abdominal aorta and peripheral arteries].

作者信息

Dominiak A B, Vlaĭkov G G, Akhmad M M

出版信息

Klin Khir. 2011 Jul(7):49-55.

Abstract

The results of examination and complex treatment of 230 patients, suffering purulent-septic complications of reconstructive operations on abdominal aorta and peripheral arteries, were analyzed. The terms of diagnosis of the infected soft tissues and transplants had constituted 4.7 years at average. There was performed complex prophylaxis and diagnosis of complications, using invasive and noninvasive methods of investigation. An important role of early diagnosis of the vascular transplant infectioning (VTI), using radionuclide scanning and leukocytes, traced with 99mTc, determination of proinflammatory interleukin-6 and anti-inflammatory interleukin-4 content while radical treatment of purulent-septic complications before arrosive hemorrhage and fistula occurrence was substantiated. The advantages of extraanatomic shunting in total VTI and sepsis, using autovenous transplants and the autologous tissue defense of the anastomoses area were shown. In 90.5% patients, in whom reoperations were performed, the results were good, the transplants passability without their reinfectioning was secured in 12 months after the operation in 71% patients.

摘要

分析了230例接受腹主动脉和外周动脉重建手术并发化脓性败血症并发症患者的检查及综合治疗结果。感染软组织和移植物的诊断期限平均为4.7年。采用侵入性和非侵入性检查方法对并发症进行了综合预防和诊断。证实了在化脓性败血症并发症的根治性治疗中,在侵蚀性出血和瘘管形成之前,利用放射性核素扫描和用99mTc追踪白细胞早期诊断血管移植物感染(VTI)、测定促炎白细胞介素-6和抗炎白细胞介素-4含量的重要作用。显示了在全VTI和败血症中使用自体静脉移植物进行解剖外分流以及吻合口区自体组织防御的优势。在接受再次手术的90.5%患者中,结果良好,71%的患者在术后12个月移植血管通畅且未再次感染。

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