计划性再手术在严重腹腔感染患者救治中的地位

目的:探讨腹部手术后患者出现消化道瘘，继发严重腹腔感染，进行计划性再手术清理腹腔感染的治疗效果。方法:回顾分析天津医科大学总医院普通外科2015 年 9 月-2018年11月共16例腹部手术后出现消化道瘘继发严重腹腔感染的患者，均应用计划性再手术。结果:通过计划性再手术，术后患者感染指标（WBC）及体温下降，APACHE II评分下降，具有统计学意义（P <0.01），除1例肝破裂、多脏器功能衰竭患者死亡外，余15例患者均恢复好转出院。结论:严重腹腔感染患者通过计划性再手术腹腔感染得到快速控制，消化道瘘愈合加速，显著降低死亡率。

The role of planned reoperation in the treatment of patients with severe abdominal infection

Objective: To investigate the patients with digestive tract fistula after abdominal surgery, secondary to severe intra-abdominal infection, with planned reoperation to clean up abdominal cavity infection. Methods: A total of 16 patients with severe intra-abdominal infection secondary to digestive tract fistula after abdominal surgery from September 2015 to November 2018 in general surgery department of general hospital of Tianjin Medical University were retrospectively analyzed, and also planned to have reoperation. Results: The postoperative infection index (WBC), body temperature, and APACHE II score were significantly decreased by this method (P<0.01). Except 1 case of death secondary to liver rupture and multiple organ failure, and the remaining patients recovered and were discharged.Conclusion: In patients with severe peritoneal infection, the peritoneal infection could be rapidly controlled through planned reoperation, and the time of healing gastrointestinal fistula can be accelerated, and the mortality was significantly reduced.