腹腔室隔综合征的早期急诊处理

Early first - aid treatment for abdominal compartment syndrome

目的 总结腹腔室隔综合征(ACS)的诊断和早期急救治疗经验。方法 11例均以间接腹腔测压和临床特征得出诊断,行早期剖腹腹腔和胃肠腔内减压引流术和非手术治疗 结果 1例死于术后呼吸功能衰竭,1例死于伤口全层裂开腹腔内感染性休克,2例死于MODS,死亡率为36.3％,7例治愈出院 结论 动态监测腹腔内压和全身变化是发现ACS的关键,并有助于手术指征和时机的确定,一旦确诊,尤其是中、重度ACS应早期开腹充分减压引流。

Objective To summarize the experiences of early diagnosis and management for abdominal compartment syndrome (ACS). Methods 11 patients were diagnosed with indirect measuring pressure in abdominal cavity and clinical characters, and given exploratory laparotomy, decompression and drainage for abdominal and gastro-intestinal cavity or non - operations. Results One of the patients died from respiratory failure after operation, one of them from infectious shock due to contamination in abdominal cavity accompanied with split of total layers within the wound,two of them from MODS.Mortality was about 36.3 percent in this group. Seven of them were cured and discharged from the hospital. Conclusions The keys to early diagnosis of ACS included continuously monitoring changes of pressure in abdominal cavity and systemic conditions.It is helpful to definiting surgical indications and the opportunity to perform operations. The patients were ill with moderate or severe ACS especially,should be given exploratory laparotomy,decompression and drainage early. The prognosis could be improved.