Zhonghua Wai Ke Za Zhi. 2021 Mar 1;59(3):161-178. doi: 10.3760/cma.j.cn112139-20201223-00874.
Intra-abdominal infections(IAIs) are common surgical emergencies and complications, which usually need multidisciplinary management including surgeons, intensivists, infectious disease experts, microbiologists, and clinical pharmacists. Based on international and domestic guidelines and recent advances, a number of experts' statements of consensus, with a problem-oriented approach, were made on the cornerstones of effective treatment of IAIs such as early recognition, etiology identification, adequate source control, and appropriate antimicrobial therapy. Main recommendations include concepts of intra-abdominal infection, pathoqen diagnosis precautions; surgical intervention principles and strategies of specific causes including acute appendicitis, upper gastrointestinal perforation, lower gastrointestinal perforation, acute biliary infection, liver abscess, severe acute pancreatitis, pancreatic fistula, biliary fistula, anastomotic leakage, gastrointestinal perforation, as well as perforation due to endoscopic procedure etc.; principles of antimicrobial therapy, dosage of antibiotics in specific population and pathophysiological state; and systematic support of severe infection such as early resuscitation and nutrition support.
腹腔内感染(IAIs)是常见的外科急症和并发症,通常需要多学科管理,包括外科医生、重症监护医生、传染病专家、微生物学家和临床药师。基于国际和国内指南以及最新进展,以问题为导向,针对IAIs有效治疗的基石,如早期识别、病因鉴定、充分的源头控制和适当的抗菌治疗等,多位专家达成了共识声明。主要建议包括腹腔内感染的概念、病原体诊断注意事项;手术干预原则以及针对特定病因(包括急性阑尾炎、上消化道穿孔、下消化道穿孔、急性胆道感染、肝脓肿、重症急性胰腺炎、胰瘘、胆瘘、吻合口漏、胃肠道穿孔以及内镜操作所致穿孔等)的策略;抗菌治疗原则、特定人群和病理生理状态下抗生素的剂量;以及对严重感染的系统支持,如早期复苏和营养支持。