Surace Alessandra, Ferrarese Alessia, Marola Silvia, Cumbo Jacopo, Valentina Gentile, Borello Alessandro, Solej Mario, Martino Valter, Nano Mario
Ann Ital Chir. 2015 Jan-Feb;86(1):46-50.
Abdominal compartment syndrome (ACS) is defined as an increase of intra-abdominal pressure (IAH) to values higher than 20 mmHg, associated with reduced perfusion and organ dysfunction.
There is a classification of open abdomen which stratifies patients according to the natural history of improvement or clinical deterioration. The aim of treatment is to maintain the open abdomen at the lowest level and to prevent progression to a more complex level.
Surgical treatment essentially consists in abdominal decompression by leaving the abdomen open. Analysis of the literature shows that negative pressure increases the rate of primary fascial closure; entero-cutaneous fistulas are seen in a minority of cases, without seeming consequence of the application of the dressing. Open abdomen management consists of three treatment stages: acute (24-48 hours), intermediate (from 48 hours to 10 days) and late or reconstruction (from 10 days to the final closure).
It's important to recognize patients at risk of IAH and the first signs of ACS and intervene early with abdominal decompression if this will establish itself. Management of the open abdomen is now facilitated by negative pressure devices, which positively affect the morbidity and mortality of patients with ACS.
腹腔间隔室综合征（ACS）定义为腹腔内压力（IAH）升高至高于20 mmHg的值，并伴有灌注减少和器官功能障碍。
有一种开放性腹部的分类方法，根据病情改善或临床恶化的自然病程对患者进行分层。治疗的目的是将开放性腹部维持在最低水平，并防止病情发展到更复杂的程度。
手术治疗主要包括通过敞开腹部进行腹腔减压。文献分析表明，负压可提高一期筋膜闭合率；少数病例会出现肠皮肤瘘，使用敷料似乎没有不良后果。开放性腹部管理包括三个治疗阶段：急性期（24 - 48小时）、中期（48小时至10天）和后期或重建期（10天至最终闭合）。
识别有IAH风险的患者以及ACS的早期迹象非常重要，如果病情发展应尽早进行腹腔减压干预。负压装置现在有助于开放性腹部的管理，对ACS患者的发病率和死亡率有积极影响。
