Buianov V M, Akhmeteli T I, Lomdze N B
Department of General Surgery, State Medical University, Tbilisi.
Khirurgiia (Mosk). 1997(8):4-7.
The results of examination and treatment of 166 patients were studied. The patients were divided into 3 groups: in the 1st (80 patients) acute generalized peritonitis was treated according to the conventional surgical canons, in the 2nd (54 patients) interchangeable plasmapheresis was added to the conventional treatment, in the 3d (32 patients) the whole complex of treatment was used--the routine method together with extracorporeal detoxication and staged sanatations of the abdominal cavity. Including plasmapheresis and staged sanatations in complex of treatment of acute generalized peritonitis intensifies the effect of treatment. The intervals between the staged sanatations and sessions of plasmapheresis depend on the stage and course of peritonitis. In the conventional method of treatment of acute generalized peritonitis according to the authors' observations the mortality rate made up 39%, when plasmapheresis was included it lowered to 30%, and when combined treatment was used mortality rate dropped to 22%. The data of this study demonstrates the potential and efficacy of combined treatment of acute generalized peritonitis with the use of interchangeable plasmapheresis and staged sanatations of the abdominal cavity.
对166例患者的检查和治疗结果进行了研究。患者被分为3组：第1组（80例患者）按照传统手术规范治疗急性弥漫性腹膜炎，第2组（54例患者）在传统治疗基础上加用交替血浆置换，第3组（32例患者）采用综合治疗方案——常规方法联合体外解毒及腹腔分期净化。在急性弥漫性腹膜炎的综合治疗中加入血浆置换和腹腔分期净化可增强治疗效果。腹腔分期净化与血浆置换疗程之间的间隔取决于腹膜炎的阶段和病程。根据作者观察，在急性弥漫性腹膜炎的传统治疗方法中死亡率为39%，加入血浆置换后降至30%，采用联合治疗时死亡率降至22%。本研究数据表明，采用交替血浆置换和腹腔分期净化联合治疗急性弥漫性腹膜炎具有潜力和疗效。
