Ciuntu Bogdan Mihnea, Vintilă Dan, Tanevski Adelina, Chiriac Ștefan, Stefănescu Gabriela, Abdulan Irina Mihaela, Balan Gheorghe G, Veliceasa Bogdan, Bădulescu Oana Viola, Ghiga Gabriela, Fătu Ana Maria, Georgescu Andrei, Vascu Mihai Bogdan, Vasilescu Alin Mihai
Department of General Surgery, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania.
Department of Gastroenterology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania.
J Clin Med. 2023 May 28;12(11):3721. doi: 10.3390/jcm12113721.
(1) Background: An open abdomen is a serious medical condition that requires prompt and effective treatment to prevent complications and improve patient outcomes. Negative pressure therapy (NPT) has emerged as a viable therapeutic option for temporary closure of the abdomen, offering several benefits over traditional methods. (2) Methods: We included 15 patients with pancreatitis who were hospitalized in the I-II Surgery Clinic of the Emergency County Hospital "St. Spiridon" from Iasi, Romania, between 2011-2018 and received NPT. (3) Results: Preoperatively, the mean IAP level was 28.62 mmHg, decreasing significantly postoperatively to 21.31 mmHg. The mean level of the highest IAP value recorded in pancreatitis patients treated with VAC did not differ significantly by lethality (30.31 vs. 28.50; = 0.810). In vacuum-treated pancreatitis patients with a IAP level > 12, the probability of survival dropped below 50% during the first 7 days of stay in the ICU, so that after 20 days the probability of survival was approximately 20%. IAP enters the determinism of surgery with a sensitivity of 92.3% and a specificity of 99%, the cut-off value of IAP being 15 mmHg. (4) Conclusions: The timing of surgical decompression in abdominal compartment syndrome is very important. Consequently, it is vital to identify a parameter, easy to measure, within the reach of any clinician, so that the indication for surgical intervention can be made judiciously and without delay.
(1) 背景：开放性腹部是一种严重的医疗状况，需要迅速有效的治疗以预防并发症并改善患者预后。负压疗法（NPT）已成为临时关闭腹部的一种可行治疗选择，相较于传统方法具有诸多优势。(2) 方法：我们纳入了2011年至2018年间在罗马尼亚雅西“圣斯皮里东”县急救医院第一 - 二外科诊所住院并接受NPT治疗的15例胰腺炎患者。(3) 结果：术前，平均腹内压（IAP）水平为28.62 mmHg，术后显著降至21.31 mmHg。接受VAC治疗的胰腺炎患者记录的最高IAP值的平均水平在致死率方面无显著差异（30.31对28.50；P = 0.810）。在IAP水平> 12的接受负压治疗的胰腺炎患者中，入住重症监护病房（ICU）的前7天内生存概率降至50%以下，因此20天后生存概率约为20%。IAP以92.3%的敏感性和99%的特异性进入手术决策，IAP的临界值为15 mmHg。(4) 结论：腹腔间隔室综合征手术减压的时机非常重要。因此，至关重要的是确定一个任何临床医生都能轻易测量的参数，以便明智且毫不拖延地做出手术干预的指征判断。
