Bondarev V I, Ablitsov N P, Baziak A P, Pipenin A V
Khirurgiia (Mosk). 1995(2):18-20.
Study showed that the suggested method for appraising the severity of the inflammatory process makes it possible to decide whether peritoneal lavage is necessary in each concrete case. The authors examined 217 patients with acute generalized peritonitis (AGP). Four degrees of the risk of a severe course of AGP were distinguished conditionally. Patients with the first degree of risk do not need intraabdominal lavage. To remove the noted inflammatory changes in the peritoneum it was sufficient to cleanse thoroughly and drain the abdominal cavity and introduce antibiotics into it during complex treatment. Intraabdominal lavage is indicated for patients with the second degree of risk and with marked inflammatory changes in moderate circulatory changes. Abdominal lavage with peritoneostomy is indicated for patients with pronounced inflammatory (N = 3.8 cond. units) and microcirculatory disorders (Y = 0.2 cond. units). Peritoneal lavage is not indicated in patients (third and fourth degrees of risk) with considerable inflammatory (N = 4.04 cond. units) and microcirculatory disorders (Y = 0.4 cond. units).
研究表明，所建议的评估炎症过程严重程度的方法能够在每个具体病例中决定是否有必要进行腹腔灌洗。作者检查了217例急性弥漫性腹膜炎（AGP）患者。有条件地区分了AGP严重病程的四级风险。一级风险患者无需进行腹腔内灌洗。在综合治疗期间，彻底清洁并引流腹腔并向其中引入抗生素，足以消除腹膜中上述炎症变化。二级风险且伴有中度循环变化中明显炎症变化的患者需要进行腹腔灌洗。对于有明显炎症（N = 3.8条件单位）和微循环障碍（Y = 0.2条件单位）的患者，需进行腹膜造口腹腔灌洗。对于有严重炎症（N = 4.04条件单位）和微循环障碍（Y = 0.4条件单位）的患者（三级和四级风险），不建议进行腹膜灌洗。
