损伤控制性外科在非外伤性大肠穿孔致严重腹腔感染的应用

Clinical Application of Damage Control Surgery in Treatment of Non-traumatic Colon Perforation with Severe Abdominal Cavity Infection

目的探讨采用损伤控制性外科(DCS)理念治疗非外伤性大肠穿孔致严重腹腔感染的经验和效果.方法回顾性分析广东省河源市人民医院普通外科2005年8月至2011年8月收治的24例非外伤性大肠穿孔致严重腹腔感染患者的损伤控制性手术和术后治疗的情况.结果 24例患者均经DCS原则予以救治,术后外科重症监护病房复苏,21例患者临床治愈出院,其中14例患者2个月后接受再次确定性手术,痊愈出院,3例术后1～7 d内死亡,死亡原因和DCS无关.结论对于大肠穿孔致严重腹腔感染患者,应积极采取DCS原则,增加患者的生存机会,并有机会行确定性手术.

Objective To explore the experience and effect of damage control surgery(DCS)in treatment of non-traumatic colon perforation with severe abdominal cavity infection.Methods 24 non-traumatic colon perforation with severe abdominal cavity infection patients who admitted in our department of general surgery from Aug.2005 to Aug.2011 were enrolled in this study.A retrospective analysis was done on the clinical data of the patients including preference of DCS methods and perioperative therapies.Results DCS was performed in all 24 patients.Then 21 patients were healed after SICU resuscitation and 14 patients among of them were performed defined reoperations after 2 months.Mortality rate was 12.5% with 3 cases in 7 days postoperation,and the causes were irrespective with DCS.Conclusion For non-traumatic colon perforation with severe abdominal cavity infection patients,DCS should be made positively to increase the survival chance of patients,and save the opportunities for them to receive defined operations.