摘要
目的探讨疝补片修补及开腹减压术对腹腔间室综合征(abdominalcompartment syndrome,ACS)伴腹腔感染患者的临床疗效,分析其应用价值。方法回顾性分析2011年4月至2018年4月,解放军第九六〇医院淄博院区收治的ACS伴腹腔感染42例患者的临床资料,根据患者及家属意愿分为2组。试验组患者18例,采用疝补片修补术;对照组患者24例,采用开腹减压修补术。比较2组患者治疗后的总有效率,治疗前后的急性生理与慢性健康状况(acute physiology and chronichealth evaluation,APACHE)Ⅱ评分,并对比分析治疗前后患者的血清炎性因子C反应蛋白(C-reactive protein,CRP)、白细胞介素6(interleukin-6,IL-6)和肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)水平。结果 2组患者治疗病情好转,试验组总有效率(83.33%)高于对照组患者(79.17%),但差异无统计学意义(P=0.773);2组患者治疗后APACHEⅡ评分均下降,但试验组患者下降程度大于对照组,差异有统计学意义(P<0.01);治疗后,患者炎症反应明显减轻,CRP、IL-6、TNF-α均下降,治疗前后差异均有统计学意义(P<0.01),且试验组患者炎症缓解程度显著大于对照组,差异有统计学意义(P<0.01)。结论疝补片修补应用于临床治疗ACS伴腹腔感染能有效改善患者血清炎性因子水平,缓解患者临床症状,有效改善患者健康状况,降低患者腹内压,为临床治疗提供新选择。
Objective To explore the clinical efficacy of herniorrhaphy and open decompression in the treatment of(ACS)with abdominal infection in patients with celiac compartment syndrome,and to analyze its application value.Methods From April 2011 to April 2018,44 cases of ACS with abdominal infection were analyzed retrospectively.Among them,18 cases were treated with herniorrhaphy and 24 cases were treated with open decompression.The clinical data of patients before and after treatment were collected,the therapeutic effects of patients after treatment were compared,the APACHEⅡscores of patients before and after treatment were compared,and the changes of serum inflammatory factors CRP,IL-6 and TNF-αbefore and after treatment were compared.Results The two groups of patients improved their treatment and had certain curative effect.The total effective rate of the experimental group(83.33%)was higher than that of the control group(79.17%),but there was no significant difference(P=0.773).The APACHEⅡscores of the two groups were decreased after treatment.The degree of decline was greater than that of the control group(P<0.01).After treatment,the inflammatory response was significantly relieved,and the inflammatory markers CRP,IL-6,and TNF-αwere decreased.There were statistical differences before and after treatment,and the degree of inflammation was significantly reduced in the experimental group.Greater than the control group(P<0.01).Conclusion Herniorrhaphy for clinical treatment of ACS with abdominal infection can effectively improve serum inflammatory factor levels,alleviate clinical symptoms,improve patient health,reduce intra-abdominal pressure,and provide new options for clinical treatment.
作者
王乃金
闫波
应浩杰
史进
马军伟
苏珂
Wang Naijin;Yan Bo;Ying Haojie;Shi Jin;Ma Junwei;Su Ke(Department of General Surgery,Zibo Hospital District,960Hospital of PLA,ShandongZibo255300,China;Department of Critical Care Medicine,Zibo Hospital District,960Hospital of PLA,ShandongZibo255300,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2019年第2期162-165,共4页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
疝补片修补
腹腔间室综合征
开腹减压术
腹腔感染
炎性因子
Herniorrhaphy
Celiac compartment syndrome
Open decompression
Severe abdominal infection
Inflammatory factor
