长期持续生理盐水输注的VAC疗法治疗继发性化脓性腹膜炎：降低围手术期风险的新策略？
VAC therapy with long term continuous saline infusion for secondary septic peritonitis: A new strategy for the reduction of perioperative risks?
作者信息
Nisi Fulvio, Marturano Federico, Natali Eleonora, Galzerano Antonio, Ricci Patrizia, Peduto Vito Aldo
机构信息
Santa Maria della Misericordia Hospital, Anaesthesiology and Intensive Care Unit Department, Perugia, Italy.
Santa Maria della Misericordia Hospital, Surgical Department, Perugia, Italy.
出版信息
Int J Surg Case Rep. 2017;32:62-65. doi: 10.1016/j.ijscr.2017.02.010. Epub 2017 Feb 13.
BACKGROUND
The management of a septic peritonitis open abdomen is a serious problem for clinicians. Open surgery is associated with several complications such as bleeding and perforation of the bowel.
CASE PRESENTATION
The authors report a case of a 59-years-old female who underwent a sigmoid resection with an latero-terminal (L-T) anastomosis for the perforation of a diverticulum. After a few days the patients developed a new widespread peritonitis. At the emergency re-laparotomy, surgeons found dehiscence of the posterior wall of the anastomosis with fecal contamination. At admission in ICU (Intensive Care Unit) the patient had open abdomen with dehiscence of cutaneous and subcutaneous layers.
CONCLUSION
Conservative therapy with antibiotic therapy and use of the Vacuum-Assisted Closure (VAC) Therapy with a long term continuous saline infusion led to the resolution of the septic shock and to the wound healing.
背景
对于临床医生而言，处理开放性腹腔的化脓性腹膜炎是一个严重问题。开放性手术会引发多种并发症，如出血和肠穿孔。
病例报告
作者报告了一例59岁女性患者，该患者因憩室穿孔接受了乙状结肠切除术及端侧吻合术。数天后，患者出现新的广泛性腹膜炎。在急诊再次剖腹手术中，外科医生发现吻合口后壁裂开并有粪便污染。患者入住重症监护病房（ICU）时，腹部开放性伤口的皮肤和皮下层裂开。
结论
采用抗生素保守治疗并使用负压封闭引流（VAC）疗法，长期持续输注生理盐水，使感染性休克得到缓解，伤口得以愈合。
Zotero 插件