腹腔扩容术在腹部外科的应用

Application of intra-abdominal volume increment in abdominai surgery

随着计算机、影像学和腹腔镜等技术的发展，以及对疾病病理、生理认识的加深，外科手术理念更新加快，提出了微创外科、精准外科和损伤控制外科等策略。外科手术技术也日新月异，发展了各类新的腔镜外科、损伤控制外科技术。其中腹腔扩容术（intra—abdominalvolumeincrement，IAVI）就是一种全新的腹部外科手术。

Intra-abdominal volume increment is a new abdominal surgery, which is used to prevent the abdominal compartment syndrome caused by intra-abdominal hypertension. In this article, the author emphasizes the concept, indications, operative principles of intra-abdominal volume increment. Firstly, laparotomy was performed, active bleeding and source of infec- tion were controlled. Then greater omentum was put under the incision, vacuseal dressings were applied on the greater omentum, and the abdominal incision was sutured. If the intra-abdominal pressure was less than 12 mm Hg （1 ram Hg = 0. 133 kPa） for 48 hours during 7-14 days after operation, abdominal incision could be closed, while if the intra-abdominal pressure was more than 12 mm Hg, dermatoplasty was used to close abdominal incision to form a ventral hernia, then definitive abdominal wall reconstruction was performed 6 months after operation.