重视胃肠道术后并发症诊断和治疗

Emphasis on diagnosis and management of complications following gastrointestinal surgery

胃肠道术后并发症是临床经常遇见的问题,术后早期腹部并发症包括腹腔内感染、消化道和腹腔内大出血、胃肠道运动障碍和伤口延时愈合等。了解不同术后并发症的相互联系,明晰其产生原因,在诊断上不仅要使用影像学等辅助诊断措施,更应重视临床症状、体征的早期发现,在治疗上非手术治疗和手术治疗应相互贯通,科学把握手术时机,恰当选择手术方式。严格术前评估、精准手术操作和严密术后监测是预防和减少术后并发症的重要环节。

Surgical complications including intra-abdominal infection, massive hemorrhage of the alimentary tract or peritoneal cavity, gastrointestinal motility disorders, and delayed wound healing remain the common problems following gastrointestinal surgery. Better understanding the relationship between different complications and their pathogenesis is extremely important. Auxiliary methods such as medical imaging have constantly been used for diagnosis. However, more attention should be paid to clinical symptoms and signs at the early stages of diseases. In addition, the combinations of nonsurgical and surgical strategies in treatment, as well as proper selection of the right operation time and the appropriate surgical procedures, are critical in the management of complications. Although complications following gastrointestinal surgery represent a clinical challenge, most of them can be prevented by rigorous preoperative evaluations, meticulous operations and careful postoperative monitoring.