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[儿童阑尾源性弥漫性化脓性腹膜炎局部治疗方法的评估]

[Evaluation of methods for local treatment of generalized purulent peritonitis of appendicular origin in children].

作者信息

Roshal L M, Pashaliev S

出版信息

Khirurgiia (Mosk). 1993 Aug(8):30-4; discussion 34-5.

PMID:8264166
Abstract

The work is based on the analysis of treatment of 212 children with generalized purulent peritonitis of appendicular origin at 7 different pediatric surgical clinics of Russia. The total mortality rate was 1.9%. It is shown that the removal of pus from the abdominal cavity by aspiration has no advantages over its removal by means of moistened tampons. Irrigation of the abdominal cavity during the operation does not affect essentially the results of treatment of patients with generalized purulent peritonitis. Drainage of the abdominal cavity by means of an aspiration drain installed properly and methodically leads to a lesser number of postoperative abdominal abscesses and continuing peritonitis. Administration of antibiotics into the abdominal cavity at the end of the operation and in the postoperative period does not influence significantly a decrease in the incidence of postoperative purulent complications. Peridural anesthesia has no advantages over other methods in the control of intestinal paresis and prevention of adhesive intestinal obstruction.

摘要

这项研究基于对俄罗斯7家不同儿科外科诊所的212例阑尾源性弥漫性化脓性腹膜炎患儿的治疗分析。总死亡率为1.9%。结果表明,通过穿刺抽吸清除腹腔脓液与使用湿纱布清除相比并无优势。手术过程中腹腔灌洗对弥漫性化脓性腹膜炎患者的治疗结果并无实质性影响。正确且系统地安装穿刺引流管进行腹腔引流,可减少术后腹腔脓肿和持续性腹膜炎的发生。手术结束时及术后在腹腔内使用抗生素对术后化脓性并发症发生率的降低并无显著影响。在控制肠麻痹和预防粘连性肠梗阻方面,硬膜外麻醉并不比其他方法更具优势。

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