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腹腔间隔室综合征:一项多学科挑战的文献综述

Abdominal Compartment Syndrome as a Multidisciplinary Challenge. A Literature Review.

作者信息

Popescu Gabriel Alexandru, Bara Tivadar, Rad Paul

机构信息

University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureş, Târgu Mureş Romania.

Surgery Clinic No. 2, Târgu Mureş, Romania.

出版信息

J Crit Care Med (Targu Mures). 2018 Oct 1;4(4):114-119. doi: 10.2478/jccm-2018-0024. eCollection 2018 Oct.

Abstract

Abdominal Compartment Syndrome (ACS), despite recent advances in medical and surgical care, is a significant cause of mortality. The purpose of this review is to present the main diagnostic and therapeutic aspects from the anesthetical and surgical points of view. Intra-abdominal hypertension may be diagnosed by measuring intra-abdominal pressure and indirectly by imaging and radiological means. Early detection of ACS is a key element in the ACS therapy. Without treatment, more than 90% of cases lead to death and according with the last reports, despite all treatment measures, the mortality rate is reported as being between 25 and 75%. There are conflicting reports as to the importance of a conservative therapy approach, although such an approach is the central to treatment guidelines of the World Society of Abdominal Compartment Syndrome, Decompressive laparotomy, although a backup solution in ACS therapy, reduces mortality by 16-37%. The open abdomen management has several variants, but negative pressure wound therapy represents the gold standard of surgical treatment.

摘要

尽管在医学和外科治疗方面取得了最新进展,但腹腔间隔室综合征(ACS)仍是一个重要的死亡原因。本综述的目的是从麻醉和外科角度介绍主要的诊断和治疗方面。腹内高压可通过测量腹内压以及通过影像学和放射学手段间接诊断。ACS的早期检测是ACS治疗的关键因素。未经治疗,超过90%的病例会导致死亡,根据最新报告,尽管采取了所有治疗措施,死亡率仍报告为25%至75%。关于保守治疗方法的重要性存在相互矛盾的报道,尽管这种方法是世界腹腔间隔室综合征协会治疗指南的核心。减压剖腹术虽然是ACS治疗中的备用解决方案,但可将死亡率降低16%至37%。开放性腹部管理有多种变体,但负压伤口治疗是外科治疗的金标准。

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