Открытый живот у пациентов с абдоминальной травмой и заболеваниями: рекомендации Всемирного общества экстренных хирургов. 2018г. [Translation of 2018 WSES guidelines: The open abdomen in trauma and non-trauma patients]

Authors

  • Translated by Denis Khokha Department of General Surgery, Mozir Hospital, Mozir
  • Vladimir Khokha Department of General Surgery, Mozir Hospital, Mozir

Keywords:

Открытый живот, лапаростомия, заболевание, травма, пациент, перитонит, панкреатит, сосудистая катастрофа, интраабдоминальная инфекция, фистула, питание, релапаротомия, закрытие, биологическая, синтетическая, сетка, техника, сроки, рекомендации.

Abstract

Открытый живот у пациентов Ñ Ð°Ð±Ð´Ð¾Ð¼Ð¸Ð½Ð°Ð»ÑŒÐ½Ð¾Ð¹ травмой и заболеваниÑми: рекомендации Ð’Ñемирного общеÑтва ÑкÑтренных хирургов. 2018г.

Ð¢ÐµÑ€Ð°Ð¿Ð¸Ñ ÐºÐ¾Ð½Ñ‚Ñ€Ð¾Ð»Ñ Ð¿Ð¾Ð²Ñ€ÐµÐ¶Ð´ÐµÐ½Ð¸Ð¹ может приводить к развитию внутрибрюшной гипертензии или абдоминальному компартмент Ñиндрому. При отÑутÑтвии декомпреÑÑии (конÑервативной или хирургичеÑкой) Ñти ÑоÑтоÑÐ½Ð¸Ñ Ð² виде порочного круга уÑугублÑÑŽÑ‚ физиологичеÑкие Ð¸Ð·Ð¼ÐµÐ½ÐµÐ½Ð¸Ñ Ð¸ полиорганную недоÑтаточноÑÑ‚ÑŒ. Более того, в Ñ€Ñде клиничеÑких Ñитуаций Ð±Ñ€ÑŽÑˆÐ½Ð°Ñ Ð¿Ð¾Ð»Ð¾ÑÑ‚ÑŒ  не может быть закрыта из-за виÑцерального отёка, невозможноÑти окончательного доÑÑ‚Ð¸Ð¶ÐµÐ½Ð¸Ñ ÐºÐ¾Ð½Ñ‚Ñ€Ð¾Ð»Ñ Ð¸Ñточника инфицированиÑ, необходимоÑти Ð²Ñ‹Ð¿Ð¾Ð»Ð½ÐµÐ½Ð¸Ñ Ñ€ÐµÐ»Ð°Ð¿Ð°Ñ€Ð¾Ñ‚Ð¾Ð¼Ð¸Ð¸ или окончаниÑ, начатой ранее операции ÐºÐ¾Ð½Ñ‚Ñ€Ð¾Ð»Ñ Ð¿Ð¾Ð²Ñ€ÐµÐ¶Ð´ÐµÐ½Ð¸Ð¹, и наличии дефекта брюшной Ñтенки. При отÑутÑтвии других альтернатив, открытый живот у пациентов Ñ Ñ‚Ñжёлой абдоминальной травмой или критичеÑкими заболеваниÑми   Ñффективен в плане профилактики и Ð»ÐµÑ‡ÐµÐ½Ð¸Ñ Ñ‚Ñжёлых физиологичеÑких отклонений. Тем не менее, его применение неоднозначно, так как Ñта методика реÑурÑо затратна, не анатомична, Ñ Ð¿Ð¾Ñ‚ÐµÐ½Ñ†Ð¸Ð°Ð»Ð¾Ð¼ Ñ‚Ñжёлых побочных Ñффектов. ПоÑтому применÑÑ‚ÑŒ открытый живот Ñледует только по Ñтрогим показаниÑм. ФаÑциальное закрытие брюшной полоÑти Ñледует выполнÑÑ‚ÑŒ как можно рано, Ñразу по доÑтижении физиологичеÑкой компенÑации.  Ðеобходимо предпринимать вÑе меры профилактики Ñ€Ð°Ð·Ð²Ð¸Ñ‚Ð¸Ñ Ð²Ð¾Ð·Ð¼Ð¾Ð¶Ð½Ñ‹Ñ… оÑложнений.


Source: this paper is an abridged translation of: Coccolini F, Roberts D, Ansaloni L, et al. The open abdomen in trauma and non-trauma patients: WSES guidelines. World J Emerg Surg 2018;13:7, DOI 10.1186/s13017-018-0167-4.

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Published

2018-07-10

How to Cite

1.
Khokha T by D, Khokha V. Открытый живот у пациентов с абдоминальной травмой и заболеваниями: рекомендации Всемирного общества экстренных хирургов. 2018г. [Translation of 2018 WSES guidelines: The open abdomen in trauma and non-trauma patients]. J Peritoneum [Internet]. 2018 Jul. 10 [cited 2024 Sep. 19];. Available from: https://joper.pagepress.net/index.php/joper/article/view/102

Issue

Guidelines in Russian

Section

Translations

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