在急性情况下处理复杂的隔膜:一篇WSES立场论文
Mario Giuffrida1, Gennaro Perrone2, Fikri Abu-Zidan3
1General Surgery Unit, Maggiore Hospital, Parma, Italy.
World journal of emergency surgery : WJES
|July 26, 2023
概括
急性腹膜 (DH) 是危及生命的. 脑电图扫描诊断DH,而腹腔镜修复是稳定患者的首选,在不稳定病例中进行开放式手术和损伤控制手术.
科学领域:
- 医学科学 医学科学 医学科学
- 手术创新 在外科创新.
- 紧急医疗 紧急医疗
背景情况:
- 急性腹膜 (DH) 是一个重大的,可能致命的临床挑战.
- 目前对隔膜间隙的管理策略仍然是持续辩论的主题.
研究的目的:
- 评估并为复杂的隔膜的管理提供建议.
- 综合有关诊断和治疗方法的当前证据.
主要方法:
- 在主要数据库中进行了全面的文献搜索.
- 关键词包括"紧急手术"",腹膜", "创伤性腹膜破裂"和"先天腹膜".
- 我们使用GRADE方法来评估证据质量并提出建议.
主要成果:
- 胸部和腹部的计算机断层扫描 (CT) 是诊断复杂的DH的黄金标准.
- 在血液动力学稳定的患者中, laparoscopic 修复是最受欢迎的,减少并发症.
- 建议使用生物和可生物吸收的网格进行修复,以尽量减少复发.
- 开放式手术和损伤控制手术对于不稳定的患者至关重要.
结论:
- 复杂的腹膜是一个罕见但危急的疾病,需要及时诊断和干预.
- 脑电图扫描是最终的诊断工具.
- laparoscopic修复为稳定的患者提供最佳结果; 开放修复和损伤控制手术对于不稳定的个人至关重要.
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