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目的探讨急腹症合并感染性休克患者的临床特点及外科治疗。方法回顾性分析95例急腹症合并感染性休克患者的临床资料。结果急腹症合并感染性休克患者原发病多为急性梗阻性化脓性胆管炎(AOSC),本组病例经紧急抗休克治疗后,手术治疗72例,治愈59例(78.7%);非手术治疗23例,治愈10例(43.4%),两组治愈率差异有统计学意义(P<0.05)。本组95例患者病死率为27.4%(26/95),主要死亡原因为多脏器功能障碍综合征(MODS),占57.7%(15/26)。治疗中并发急性呼吸窘迫综合征(ARDS)和急性肾功能衰竭比较常见,发生率分别为35.8%(34/95)和30.5%(29/95)。结论急腹症合并感染性体克的治疗对策应首先积极抗体克治疗保持血流动力学稳定,同时选择合适的时机及时手术,注意控制感染并早期防治MODS,以上措施的综合运用可以明显提高治愈率。
Objective To investigate the clinical features and surgical treatment of acute abdomen patients with septic shock. Methods The clinical data of 95 acute abdomen patients with septic shock were retrospectively analyzed. Results Acute obstructive suppurative cholangitis (AOSC) was the most common primary cause of acute abdomen infection in septic shock. After emergency anti-shock therapy, 72 cases were cured by surgery, and 59 cases were cured (78.7%). Non-surgical Treatment of 23 cases, 10 cases were cured (43.4%), the cure rate difference between the two groups was statistically significant (P <0.05). The 95 patients died of this group was 27.4% (26/95), the main cause of death was multiple organ dysfunction syndrome (MODS), accounting for 57.7% (15/26). Treatment of acute respiratory distress syndrome (ARDS) and acute renal failure are more common, the incidence rates were 35.8% (34/95) and 30.5% (29/95). Conclusions The treatment of acute abdomen complicated with infectious body g should first be actively treated with anti-body g to maintain hemodynamics stability, and select the appropriate timing and timely surgery, pay attention to the control of infection and early prevention and treatment of MODS, comprehensive utilization of these measures can significantly improve the cure rate.