腹腔负压填塞在腹腔感染合并腹腔大出血中的应用

Abdominal packing for hemorrhea due to intra-abdominal infection

目的:腹腔感染合并腹腔大出血病情危重,需要及时有效的止血和引流。应用腹腔填塞方法,观察其临床效果。方法:回顾分析2003年2月至2007年4月20例腹腔感染合并腹腔大出血患者,其中男16例,女4例,年龄23～72岁,平均年龄(43.5±15.0)岁,其中胰周和腹膜后出血14例,肠瘘口及周围脓腔出血6例。结果:20例患者均应用腹腔负压填塞,填塞后存活16例(80%),且无一例患者有感染加重的现象,纱布取除时亦无再出血的现象,另有4例患者死亡。14例患者在腹腔负压填塞后关闭腹腔,另6例行腹腔开放。纱布填塞后有2例患者再次出血,于床边再次填塞后出血停止。纱布取出时间为2～7 d,平均为(4.8±1.1)d。结论:腹腔负压填塞是处理腹腔感染合并大出血的有效治疗方式。

Objective： Abdominal hemorrhea induced by intra-abdominal infection is a critical pathogenetic condition,which requires prompt hemostasis and drainage.The present paper aims to investigate the clinical effect of abdominal gauze packing with sump drainage in the management of this condition.Methods： We retrospectively analyzed 20 cases of abdominal hemorrhea due to intra-abdominal infection who were treated by abdominal gauze packing with sump drainage from February 2003 to April 2007.The patients,16 males and 4 females,averaged（43.5±15.0）（23-72） years in age.Peripancreatic and retroperitoneal hemorrhage occurred in 14 cases,and intestinal fistula and vomica hemorrhage in 6.Results： Of the total number of patients,16（80%） survived without aggravated infection and rebleeding after removal of the gauze,and the other 4 died.The abdomens were closed 14 and opened in 6 patients following abdominal packing.Rebleeding occurred in 2 cases after the packing but was controlled by bedside re-packing.The mean packing period was（4.8±1.1）（2-7） days.Conclusion： Abdominal packing with sump drainage is a safe,simple,and effective procedure for abdominal hemorrhea induced by intra-abdominal infection.