Open Abdomen Therapy In The Management Of Severe Evtra-Abdominal Infection:an Retrospective Analysis Of 13 Cases

Objective Summary of the First Affiliated Hospital of Guangxi Medical University with the open abdomen therapy of 13 cases of severe intra-abdominal infection patients,to explore the open abdomen therapy clinical effect in treating severe intra-abdominal infection.Methods A retrospective analysis of the diagnosed with severe abdominal infection 106 hospitalized cases in the First Affiliated Hospital of Guangxi Medical University from February 2013 to February 2016, review the clinical data of the 13 cases with open abdomen therapy, Including the open abdomen before 1 day and after 1,3,5,7,10,15 day of blood routine,C-reactive protein,liver and kidney function,electrolyte, procalcitonin,blood gas analysis,intra-abdominal pressure results.These indicators collected Acute Physiology and Chronic Health Evaluation (APACHE II),discusses the change of APACHE II score,intra-abdominal pressure,body temperature,white blood cell, neutrophil percentage, C-reactive protein and procalcitonin.Results 13 cases of severe intra-abdominal infection patients, male 13 cases (100%),Age 21 to 63,the median age 44,the average age of 42.4±11.9.Severe acute pancreatitis complicated with severe intra-abdominal infection(10 cases),postoperative abdominal trauma complicated with severe intra-abdominal infection(3 cases).13 cases were underwent open abdomen therapy, of which 1 case in the outer court has been open abdomen,7 cases (53.8%) underwent open abdomen therapy be cured(cure group) and 4 cases (30.8%) died and 2 cases (15.4%) to give up treatment (death and gave up treatment referred to as death and give up treatment group).The main causes of death due to infection and organ function failure(2 cases),abdominal bleeding (1 case), respiratory and cardiac arrest (1 case).1 day before open abdomen of the APACHE II score in the cure group and death group respectively 21.6 ±3.4 and 24.3±6.3,3 days after open abdomen were dropped to 10.7±3.9 and 11.3±4.2,10 days after open abdomen,the cure group APACHE II score dropped to 7.4±3.5,and death group score rise again to 18.0±10.8.The intra-abdominal pressure,body temperature,white blood cell,neutrophil percentage,C-reactive protein and procalcitonin of the patients in the cure group and the death group were significantly decreased compared with before.The hospitalization time was from 23 days to 139 days,average time was 45.3 days.The defintive abdominal closure time was from 7 days to 15 days,average time was 12.0 days.The highest treatment cost was 130.5 million yuan,average cost was 32.5 million yuan.Conclusions The open abdomen therapy can be effective in the treatment of severe intra-abdominal infection, and timely application of open abdomen therapy can effectively improve the severity of severe intra-abdominal infection, and it is worthy of clinical application.