开放性腹部的整体管理。
Total management of the open abdomen.
机构信息
Department of Surgery, Division of Trauma, Emergency Surgery and Surgical Critical Care, University of Southern California, Keck School of Medicine, Los Angeles, CA 90033, USA.
出版信息
Int Wound J. 2012 Aug;9 Suppl 1(Suppl 1):17-24. doi: 10.1111/j.1742-481X.2012.01018.x.
Abstract
The management of complex abdominal problems with the 'open abdomen' (OA) technique has become a routine procedure in surgery. The number of cases treated with an OA has increased dramatically because of the popularisation of damage control for life-threatening conditions, recognition and treatment of intra-abdominal hypertension and abdominal compartment syndrome and new evidence regarding the management of severe intra-abdominal sepsis. Although OA has saved numerous lives and has addressed many problems related to the primary pathology, this technique is also associated with serious complications. New knowledge about the pathophysiology of the OA and the development of new technologies for temporary abdominal wall closure (e.g. ABThera™ Open Abdomen Negative Pressure Therapy; KCI USA Inc., San Antonio, TX) has helped improve the management and outcomes of these patients. This review will merge expert physician opinion with scientific evidence regarding the total management of the OA.
摘要
采用“开放性腹部（OA）”技术来处理复杂腹部问题已成为外科手术中的常规程序。由于严重威胁生命状况的损伤控制、腹内高压和腹腔间隔室综合征的认识和治疗以及关于严重腹腔内感染处理的新证据的普及，采用 OA 治疗的病例数量急剧增加。虽然 OA 挽救了许多生命，并解决了许多与原发性疾病相关的问题，但该技术也与严重并发症有关。关于 OA 病理生理学的新知识和用于临时腹壁闭合的新技术（例如 ABThera™开放性腹部负压治疗；KCI USA Inc.，圣安东尼奥，TX）的发展有助于改善这些患者的治疗和预后。这篇综述将专家医生的意见与关于 OA 整体管理的科学证据相结合。
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本文引用的文献
1
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Surg Innov. 2012 Dec;19(4):353-63. doi: 10.1177/1553350611429693. Epub 2012 Jan 5.
2
Peritoneal negative pressure therapy prevents multiple organ injury in a chronic porcine sepsis and ischemia/reperfusion model.腹腔负压治疗可预防慢性猪脓毒症和缺血/再灌注模型中的多器官损伤。
Shock. 2010 Nov;34(5):525-34. doi: 10.1097/SHK.0b013e3181e14cd2.
3
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Am Surg. 2009 Nov;75(11 Suppl):S1-22.
4
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5
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7
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8
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9
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J Wound Ostomy Continence Nurs. 2007 Jul-Aug;34(4):428-30. doi: 10.1097/01.WON.0000281661.77086.d1.
10
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