儿童弥漫性化脓腹膜炎术前准备的差异性处理方法
- 作者: Zavyalkin V.A.1, Barskaya M.A.1, Yukhimets S.N.2
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隶属关系:
- Samara State Medical University
- St. Joseph University in Tanzania
- 期: 卷 14, 编号 1 (2024)
- 页面: 57-68
- 栏目: Original Study Articles
- URL: https://journals.rcsi.science/2219-4061/article/view/257474
- DOI: https://doi.org/10.17816/psaic1570
- ID: 257474
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全文:
详细
论证。弥漫性化脓腹膜炎是腹部外科病理中最严重的并发症,并伴有严重的代谢紊乱。消除这些紊乱是术前准备的任务。
目的。本研究的目的是比较传统的术前准备和新的治疗方案,新治疗方案会考虑腹膜炎的阶段、 内毒素血症的程度、患儿的年龄和琥珀酸盐的用量。
材料与方法。对2006年至2022年在V.D. Seredavin Samara Regional Hospital儿童外科接受治疗的1-14岁(平均年龄7.9±3.9岁) 不同病因的弥漫性化脓腹膜炎患者的治疗结果进行了分析。 患者被分为两组。主要治疗组包括237名患者,他们按照建议的方案(取决于年龄、腹膜炎阶段和内毒素血症程度)进行了至少4-6小时的术前准备。使用抗氧剂琥珀酸葡甲胺钠(Reamberin®)进行体外排毒。对照组包括102名儿童,他们按照公认的方法和国家儿科手术指南接受了常规治疗,治疗时间为2-3小时。综合检查包括研究血流动力学参数、电解质、血细胞比容、血小板和血气等指标的变化。
结果。术前准备后,主要组的血流动力学指标比对照组在统计学上有更为明显的改善,接近正常值。血液学参数的动态变化表明,主治疗组各年龄段患者的血液稀释更为明显,这证明血液流变学性质有明显改善。各组的电解质和血气指标均未达到健康儿童的指标,但主要组的指数更接近正常值。主要治疗组中有21名患儿(8.8±1.4;P<0.001)出现了不同程度的并发症,而对照组中有47名患儿(46.0±4.6%)确诊出现了并发症。根据统计,主治疗组80的患儿术后在重症监护室的住院时间明显缩短。
结论。1.与传统治疗方法相比,基于差异化治疗方法并使用Reamberin®的术前准备方案具有更高的疗效。2. 术前准备的组成、范围和持续时间取决于患者的平衡状态和年龄。
作者简介
Vladislav A. Zavyalkin
Samara State Medical University
Email: v.a.zavyalkin@samsmu.ru
ORCID iD: 0000-0001-9555-8979
SPIN 代码: 8691-8689
MD, Cand. Sci. (Medicine), Associate Professor
俄罗斯联邦, SamaraMargarita A. Barskaya
Samara State Medical University
Email: m.a.barskaya@samsmu.ru
ORCID iD: 0000-0002-7069-7267
SPIN 代码: 6604-3686
MD, Dr. Sci. (Medicine), Professor
俄罗斯联邦, SamaraSergey N. Yukhimets
St. Joseph University in Tanzania
编辑信件的主要联系方式.
Email: ast_dean_sm@sjchs.sjuit.ac.tz
ORCID iD: 0000-0002-2493-7872
SPIN 代码: 7981-4639
MD, Cand. Sci. (Medicine), Associate Professor
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