Tsuman V G, Duriagin D S, Shcherbina V I, Semilov E A, Mashkov A E, Kosarev V A
Khirurgiia (Mosk). 1993 Aug(8):35-9.
Experience in the treatment of 137 children with a most severe and complicated course of generalized purulent peritonitis of appendicular genesis is generalized. It is shown that such patients must be concentrated in centers of pediatric surgery providing the possibility of applying a complex of diagnostic examinations and therapeutic measures, including purposeful antibiotic therapy, differentiated immunocorrection, and effective detoxification. The detoxification and immunocorrection effect of discrete plasmapheresis with two-stage "washing out" of the red cells is illustrated in the discussion of 22 cases. It is pointed out that in operations for generalized purulent peritonitis the abdominal cavity must not only be cleansed but also drained adequately and intubation of the intestine must be carried out with aspiration of its content for 3-5 days and application of enterosorption through an intestinal tube. A complex of organizational and therapeutic measures made it possible to reduce considerably the mortality rate in acute appendicitis and its complications in the Moscow Region.
总结了对137例患有最严重且复杂的阑尾源性弥漫性化脓性腹膜炎病程儿童的治疗经验。结果表明，此类患者必须集中在小儿外科中心，以便能够进行一系列诊断检查和治疗措施，包括有针对性的抗生素治疗、差异化免疫纠正和有效的解毒治疗。在对22例病例的讨论中阐述了采用两阶段“洗脱”红细胞的间断性血浆置换的解毒和免疫纠正效果。指出在弥漫性化脓性腹膜炎手术中，不仅必须清洁腹腔，还必须充分引流，并且必须对肠道进行插管，抽吸其内容物3 - 5天，并通过肠管进行肠吸附。一系列组织和治疗措施使得莫斯科地区急性阑尾炎及其并发症的死亡率大幅降低。
