外科常见腹腔感染多学科诊治专家共识

腹腔感染是临床常见的急危重症之一,其诊治涉及外科、重症医学、感染、检验、临床药学等多个学科,包括局部病灶处置、病原学检测、抗菌药物合理应用及因感染导致的全身各系统异常状况纠正等过程,具有特殊性及复杂性。本共识参考国内外最新进展并结合临床经验,以问题为导向,以循证为基础,对急性阑尾炎、上消化道穿孔、下消化道穿孔、急性胆道感染、肝脓肿、重症急性胰腺炎、胰瘘、胆瘘、吻合口瘘、内镜诊治后消化道穿孔等外科常见腹腔感染的诊断、病原学检测、外科及抗菌药物治疗等临床热点问题进行评述,并根据证据等级提出诊治相关的推荐意见,旨在规范外科常见腹腔感染的诊疗行为,在临床决策、抗菌药物应用等方面为临床医师提供参考及指导,以提高诊治水平并改善患者预后。

Expert consensus on multidisciplinary management of intra-abdominal infections

Intra-abdominal infections(IAIs)are common surgical emergencies and complications,which usually need multidisciplinary management including surgeons,intensivists,infectious disease experts,microbiologists,and clinical pharmacists.Based on international and domestic guidelines and recent advances,a number of experts′statements of consensus,with a problem-oriented approach,were made on the cornerstones of effective treatment of IAIs such as early recognition,etiology identification,adequate source control,and appropriate antimicrobial therapy.Main recommendations include concepts of intra-abdominal infection,pathoqen diagnosis precautions;surgical intervention principles and strategies of specific causes including acute appendicitis,upper gastrointestinal perforation,lower gastrointestinal perforation,acute biliary infection,liver abscess,severe acute pancreatitis,pancreatic fistula,biliary fistula,anastomotic leakage,gastrointestinal perforation,as well as perforation due to endoscopic procedure etc.;principles of antimicrobial therapy,dosage of antibiotics in specific population and pathophysiological state;and systematic support of severe infection such as early resuscitation and nutrition support.