[重症监护病房开放性腹部患者的临床特征。一项回顾性分析]
[Clinical characteristics of patients with open abdomen at ICU. A retrospective analysis].
作者信息
Navarro-Chagoya María Dolores, Tejeda-Huezo Brigitte Del Carmen, Gómez-Flores Saira Sanjuana, Sánchez-Hurtado Luis Alejandro
机构信息
Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Servicio de Cirugía General. Ciudad de México, México.
Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Unidad de Cuidados Intensivos. Ciudad de México, México.
出版信息
Rev Med Inst Mex Seguro Soc. 2020 Apr 13;58(2):108-113. doi: 10.24875/RMIMSS.M20000007.
BACKGROUND
The open abdomen is a surgical management strategy in patients with increased intra-abdominal pressure or when the abdominal wall cannot be closed.
OBJECTIVE
The aim of this study is to describe the characteristics and clinical outcome of a group of surgical patients with open abdomen who have been admitted to an ICU.
MATERIAL AND MEHOTDS
Retrospective study in an ICU of a public hospital of reference with subjects admitted with open abdomen. The clinical and demographic characteristics were recorded upon admission to the ICU and were associated with the risk of death in the ICU.
RESULTS
We included 30 patients, with mean of age 51.97 ± 17.77 years. The main reason for admission to the ICU was abdominal sepsis. The severity of the disease by APACHE II was median of 14 points and a SOFA with median of 4.5 points. The lethality in ICU was 46.7%.
CONCLUSION
The mortality of patients with open abdomen in ICU is high. Surviving subjects have higher number of surgical reoperations and a greater risk of whole cutaneous fistulas.
背景
开放腹腔是治疗腹腔内压力升高或腹壁无法关闭患者的一种外科治疗策略。
目的
本研究旨在描述一组入住重症监护病房（ICU）的开放性腹部手术患者的特征和临床结局。
材料与方法
在一所公立医院的ICU对开放性腹部手术患者进行回顾性研究。记录患者入住ICU时的临床和人口统计学特征，并分析其与ICU死亡风险的相关性。
结果
我们纳入了30例患者，平均年龄为51.97±17.77岁。入住ICU的主要原因是腹部感染。急性生理与慢性健康状况评分系统（APACHE II）评分为14分（中位数），序贯器官衰竭评估（SOFA）评分为4.5分（中位数）。ICU死亡率为46.7%。
结论
ICU中开放性腹部手术患者的死亡率很高。存活患者的再次手术次数更多，全层皮肤瘘的风险更大。
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