疝修补术后腹腔间隔室综合征预防与处理中国专家共识(2022版)

Chinese expert consensus on prevention and treatment of abdominal compartment syndrome after herniorrhaphy(2022 edition)

腹腔间隔室综合征(ACS)由于持续性腹内压增高导致机体一系列的病理生理改变,从而诱发多器官功能不全或衰竭,是临床上最危重的并发症之一。多种原因可导致ACS,其中疝修补术,尤其是巨大腹壁疝或巨大腹股沟疝修补手术是ACS的重要诱发因素之一,但目前较少有针对性的系统性阐述或共识意见。本共识以疝修补术后ACS为重点,从相关危险因素、术前预防、术中决策、术后监测及ACS的处理等方面进行阐述,同时提出与临床密切相关的焦点问题,结合循证医学证据展开讨论并给出推荐意见。旨在提高临床医生,尤其是疝外科医生对该综合征的认识,以及预防与处理的能力。

Abdominal compartment syndrome(ACS) is one of the most severe complications in clinical practice, which is caused by a series of pathophysiological changes in the body due to the continuous increase of intra-abdominal pressure, thus inducing multiple organ dysfunction or failure. Various reasons can cause ACS. Herniorrhaphy, especially the repair of a vast abdominal wall hernia or a giant inguinal hernia, is one of the important predisposing factors for ACS. Still, there are few specific systematic statements or consensus opinions. This consensus focuses on the postoperative ACS of herniorrhaphy, elaborates on the related risk factors, preoperative preventive measures, intraoperative decision-making, postoperative monitoring, and ACS treatment, and puts forward the focus issues closely related to clinical settings, discusses and gives recommendations based on evidence-based medicine, so as to improve the understanding as well as the prevention and treatment ability of clinicians, especially hernia surgeons, on this condition.