Popescu Gabriel Alexandru, Bara Tivadar, Rad Paul
University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureş, Târgu Mureş Romania.
Surgery Clinic No. 2, Târgu Mureş, Romania.
J Crit Care Med (Targu Mures). 2018 Oct 1;4(4):114-119. doi: 10.2478/jccm-2018-0024. eCollection 2018 Oct.
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.
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。