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腹腔开放疗法在腹部创伤的应用
Open abdomen therapy in the management of abdominal trauma

腹腔开放疗法在腹部创伤的应用

ISSN:1009-4237
2015年第3期
任建安 REN Jian-an
南京军区南京总医院, 江苏,210002 REN Jian-an;Nanjing General Hospital of Nanjing Command;

腹腔开放疗法是治疗严重腹部创伤患者的一项重要损害控制外科进展。腹腔开放疗法可用于腹部实质性脏器破裂特别是肝脏破裂使用纱布填塞法止血的患者、腹腔高压合并多脏器功能障碍和腹部创伤伴腹腔严重污染或严重感染患者。腹腔开放达到治疗目的后,应首先考虑尽早全层关腹。如二期全层关腹有困难,按阶段性治疗策略施行腹腔开放疗法,即将腹腔开放疗法分为早期开放、中期维持和后期腹壁重建阶段。腹腔开放疗法需要重点防治的并发症包括肠空气瘘和腹壁缺损。

Open abdomen therapy is one of the most important damage control surgical procedures in the management of abdominal surgery. Open abdomen therapy can be used in severe hepatic injury complicated with massive bleeding,high intra-abdominal pressure with consequent multiple organs dysfunction and severe intra-ab-dominal infection after abdominal trauma.Abdomen could be closed by delayed facial closure after the bleeding or infection are controlled.The open abdomen could be managed by stages including early opening,maintaining and intestinal and abdominal wall reconstruction.Enteroatmospheric fistulae and abdominal defect are the two most fre-quent complications that should be prevented and treated.

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ISSN:1009-4237
2015年第3期

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