用负压伤口治疗系统治疗严重急性胰腺炎:实验室标记物的影响
Bogdan Mihnea Ciuntu1, Dan Vintilă1, Adelina Tanevski1
1Department of General Surgery, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania.
Journal of clinical medicine
|June 10, 2023
概括
负压疗法 (NPT) 在胰腺炎患者中有效降低腹内压力 (IAP). 迅速进行手术减压至关重要,IAP切线为15 mmHg,表明手术风险很高.
科学领域:
- 腹部外科手术 腹部外科手术
- 关键护理医学 关键护理医学
- 手术创新 在外科创新.
背景情况:
- 腹部开放的管理带来了重大的临床挑战.
- 负压疗法 (NPT) 为暂时的腹部闭塞提供了一个有希望的方法.
- 对于开放腹部的传统治疗方法,NPT显示了潜在的益处.
研究的目的:
- 评估NPT在治疗腹部开放的胰腺炎患者中的疗效.
- 为了评估NPT对本群体腹内压力 (IAP) 的影响.
- 为了确定IAP在接受NPT的胰腺炎患者的预后价值.
主要方法:
- 一项追溯研究,对15名胰腺炎患者进行了研究,这些患者在2011-2018年期间接受了NPT治疗.
- 在手术前和手术后监测腹腔内压力 (IAP).
- 与患者死亡率和生存率相关的IAP水平的分析.
主要成果:
- 在NPT中,平均IAP从手术前的28.62 mmHg显著降低到手术后的21.31 mmHg.
- 在接受NPT治疗的患者中,增加IAP (>12 mmHg) 与在7天内生存概率低于50%的相关性.
- IAP显示了高的诊断准确性 (92.3%的灵敏度,99%的特异性),手术干预的切断值为15mmHg.
结论:
- 及时进行手术减压对于治疗腹腔综合征至关重要.
- 腹腔内压力是指导手术干预的关键,易于测量的参数.
- 基于IAP监测的明智和及时的外科干预可以改善患者的治疗结果.
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