宫颈癌根治术后腹腔间隔综合征一例诊治体会

腹腔间隔综合征(abdominal compartment syndrome,ACS)是开腹手术较为罕见的并发症,死亡率高。结合1例宫颈恶性肿瘤根治术后ACS合并切口裂开的病例,强调对于高危患者准确监测腹内压和及时剖腹手术的重要性。该患者极度肥胖,体质量指数(BMI)=40 kg/m^2,两次新辅助化疗后行宫颈癌根治术(经腹广泛子宫、双侧卵巢、双侧输卵管切除术,盆腔淋巴结切除术),术后第1天,持续腹胀咳嗽;术后第4天出现ACS,行开腹减压术。术后恢复良好,经过10个月的随访,未见并发症。

A Case Report of the Diagnosis and Treatment of the Abdominal Compartment Syndrome after Radical Hysterectomy of Cervical Cancer

Abdominal Compartment Syndrome(ACS)is a rare complication with a high death rate in laparotomy.We report a case of ACS complicated with incision dehiscence after radical resection of cervical malignant tumor,and emphasize the importance of accurate monitoring of intra-abdominal pressure and timely laparotomy in high-risk patients.This was a extremely obese patient,BMI=40 kg/m2.She was performed radical hysterectomy for cervical cancer(extensive abdominal hysterectomy,bilateral ovaries,bilateral oviducts ectomy,pelvic lymphadenectomy)after two rounds of neoadjuvant chemotherapy.On the first day after operation,the patient continued to suffer from abdominal distention and cough.ACS was found on the 4 th day after operation and Laparotomy was timely performed.The postoperative recovery was good.After 10 months follow-up,there are no signs of complications.