术后腹腔感染的挑战与治疗对策

术后腹腔感染(PIAI)是临床上严峻的挑战,全球PIAI的死亡率仍居高不下,早期诊断与及时有效治疗至关重要.如果没有及时有效的治疗,会面临导致治疗失败的高风险因素如耐药菌感染、慢性危重症、腹腔高压及多器官功能障碍等的威胁.合理的抗菌药物应用、及时的感染源控制以及包括对抗脓毒症、器官功能维护与营养治疗等在内的支持治疗是治...

Challenges and treatment strategies of postoperative intra-abdominal infection

Postoperative intra-abdominal infection(PIAI)is still a serious clinical challenge,and with high mortality across the global.Early diagnosis and timely therapy are the key element.Without prompt and effective treatment,PIAI will face with the threat of drug-resistant bacteria infection,chronic critical illness,intra-abdominal hypertension and multiple organ dysfunction,which will cause treatment failure.Rational application of antibiotics,prompt source control and supportive treatment including against sepsis,organ function protection and nutritional therapy are the key points of treatment.Source control is the fundamental treatment of PIAI,but the existing source control measures have not been standardized.It is recommended to implement the step-up approach of source control for PIAI.Establishment of active drainage with minimally invasive is the first step,surgical drainage should be performed when active drainage fails to control the source of infection and the open abdomen therapy should be implemented for PIAI complicated with intraabdominal hypertension.