[在患有腹部癌症的患者中,真空辅助腹腔解剖术用于扩散性术后腹膜炎]
I B Uvarov1,2, A M Manuilov1, D D Sichinava2
1Kuban State Medical University, Krasnodar, Russia.
Khirurgiia
|April 9, 2025
概括
真空辅助腹腔切除术 (VAL) 与按需复腹切除术相比,在扩散性术后腹膜炎 (DPP) 中显著降低了死亡率和发病率. 这种方法可以更好地控制炎症过程和腹内压力.
科学领域:
- 手术瘤学手术瘤学
- 关键护理医学 关键护理医学
- 腹部手术 腹部手术
背景情况:
- 扩散性术后腹膜炎 (DPP) 在腹部癌症患者中提出了重大挑战.
- 目前的管理策略往往涉及按需的复发器切除术,这可能导致高发病率和死亡率.
- 改善DPP的结果需要创新的方法来管理开放的腹部和控制腹内败血症.
研究的目的:
- 评估真空辅助腹腔整形术 (VAL) 与分阶段腹洗在DPP患者的疗效.
- 为了比较VAL的结果与传统的要求重复腹腔切除术 (RD).
- 评估VAL对死亡率,发病率,腹腔状况和关闭率的影响.
主要方法:
- 一项对141名患有DPP的患者进行的比较研究,分为两组:VAL (n=63) 和RD (n=78).
- 使用商业真空系统进行负压治疗,每48-72小时更换一次带.
- 评估的结果包括死亡率,Clavien-Dindo并发症,腹腔状况的Björck分类和初级关闭发生率.
主要成果:
- 死亡率在VAL组 (15.9%) 与RD组 (30.8%) 相比显著较低 (p=0.040).
- 严重的并发症 (Clavien-Dindo 3-5级) 在VAL.中较少发生.
- VAL有助于更好地控制腹腔状态,在63.5%的患者中实现了初级带关闭.
结论:
- 虚空辅助腹腔切除术是与按需复腹切除术相比,用于扩散性术后腹膜炎的优越治疗方法.
- VAL证明了死亡率和发病率的降低.
- 这种技术可以改善局部炎症过程的控制和腹内压力管理.
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