Muhrer K H, Grimm B, Wagner K H, Börner U
Chirurg. 1985 Dec;56(12):789-97.
In 27 patients with severe diffuse purulent or fecal peritonitis planned relaparotomies with peritoneal lavage or continuous dorsoventral lavage with open abdomen were performed after surgical treatment of the primary infection. During the course of the lavage treatment serum endotoxin was measured daily. The endotoxin-induced liberation of lysosomal proteases was studied by determining the elastase from polymorphonuclear leucocytes. 16 surviving patients showed decreasing endotoxin levels and decreasing elastase concentrations during the course of abdominal lavages. Planned peritoneal lavage and continuous dorso-ventral lavage seem to have the same potency in eliminating endotoxin from the infected peritoneal cavity. In letal courses endotoxinemia either persisted at high levels or even progressed inspite of lavage treatment.
在27例患有严重弥漫性脓性或粪性腹膜炎的患者中，在对原发性感染进行手术治疗后，计划进行再次剖腹手术并进行腹腔灌洗，或采用开放腹腔的持续腹背灌洗。在灌洗治疗过程中，每天测量血清内毒素。通过测定多形核白细胞中的弹性蛋白酶来研究内毒素诱导的溶酶体蛋白酶释放。16例存活患者在腹腔灌洗过程中内毒素水平降低，弹性蛋白酶浓度降低。计划性腹腔灌洗和持续腹背灌洗在清除感染腹腔内毒素方面似乎具有相同的效力。在致死病程中，尽管进行了灌洗治疗，内毒素血症要么持续处于高水平，要么甚至进展。
