腹部外科脓毒症临床救治258例

目的:探索降低腹部外科脓毒症患者病死率的具体综合治疗措施.方法:整体治疗时,在“炎性介质、细菌、内外毒素、微循环、免疫功能、营养代谢、基础疾病、脏器功能”等方面进行兼顾和并治,相应实施14条具体治疗措施.提出了短程山莨菪碱联用地塞米松为主的综合救治方案;提出并应用“分阶段代谢营养支持”治疗,减少严重并发症的发生率;采用自制的“解毒固本汤”配合治疗,以改善免疫紊乱状态、调控炎性介质等.结果:本组腹部外科脓毒症258例患者,总计死亡30例,死亡率为11.62%.结论:采用综合救治新对策能降低腹部外科脓毒症的死亡率.

Clinical treatment of severe sepsis in abdominal surgery: an anlysis of 258 cases

AIM: To explore a compositive treatment for reducing the mortality rate of the severe sepsis in abdominal surgery.METHODS: While general treatment was per-formed, 14 concrete measures were carried out in accordance with the following factors: in? amma-tory mediator, bacteria, extoxin and endotoxin, dysfunction of microcirculation, immunity, nutri-tion, metabolism, basic diseases, and the function of organs. The combination of high dosage of anisodaminum and dexamethason was used in the short-term treatment. The nutrition support was used according to different stages of multiple organ dysfunction syndrome (MODS). Jiedu Guben Tang was orally administratered to regulate the imbalance of immunity and the in? ammatory me-diators.RESULTS: A total of 30 patients were died in the 258 patients, and the mortality rate was 11.62%.CONCLUSION: The new compositive treatment can signifi cantly reduce the mortality of severe sepsis in abdominal surgery.