Foothills Medical Centre, Department of Critical Care Medicine and Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
HUS Helsinki University Hospital, Helsinki, Finland.
Scand J Surg. 2021 Jun;110(2):139-149. doi: 10.1177/1457496920984078. Epub 2021 Jan 7.
Secondary peritonitis and intra-abdominal sepsis are a global health problem. The life-threatening systemic insult that results from intra-abdominal sepsis has been extensively studied and remains somewhat poorly understood. While local surgical therapy for perforation of the abdominal viscera is an age-old therapy, systemic therapies to control the subsequent systemic inflammatory response are scarce. Advancements in critical care have led to improved outcomes in secondary peritonitis. The understanding of the effect of secondary peritonitis on the human microbiome is an evolving field and has yielded potential therapeutic targets. This review of secondary peritonitis discusses the history, classification, pathophysiology, diagnosis, treatment, and future directions of the management of secondary peritonitis. Ongoing clinical studies in the treatment of secondary peritonitis and the open abdomen are discussed.
继发性腹膜炎和腹腔内感染是一个全球性的健康问题。腹腔内感染导致的危及生命的全身炎症反应已经得到了广泛的研究，但仍有些方面尚未被完全理解。虽然针对腹部内脏穿孔的局部手术治疗是一种古老的治疗方法，但控制随后全身炎症反应的系统治疗方法却很少。重症监护的进步导致继发性腹膜炎的治疗效果得到了改善。对继发性腹膜炎对人类微生物组影响的理解是一个不断发展的领域，并产生了潜在的治疗靶点。本文对继发性腹膜炎进行了综述，讨论了继发性腹膜炎的历史、分类、病理生理学、诊断、治疗以及未来的管理方向。还讨论了正在进行的继发性腹膜炎和开放性腹部治疗的临床研究。
