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急性胰腺炎合并腹腔间隔综合症英语课件.ppt

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该【急性胰腺炎合并腹腔间隔综合症英语课件】是由【luyinyzhi】上传分享，文档一共【22】页，该文档可以免费在线阅读，需要了解更多关于【急性胰腺炎合并腹腔间隔综合症英语课件】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。CaseReport
AbdominalCompartmentSymdrom
inAPatientwithSevereAcutePancreatitis
Admission
A56-year-oldmalewasadmittedtoSICUofResearchInstituteofGeneralSurgery,JinlingHospitalon20thOct2003
Hesufferdfromepigastricpainfortwodays,dyspneaanddecreasedurineoutputforonedayafterafatrichdiet
PEonAdmission
T38℃,HR140bpm,RR30/min,BP82/58mmHg
Oxygensaturation92%
Acutefacewithshortnessofbreath,inagitatedstate,fardistendedabdomenwithhightension,signsofdiffusiveperitonitis,weakbowelsounds
Bloodyasciteswasdrawnoutbydiagnosticpuncture
Urineoutputdecreasedfurtherandanuriadeveloped
Diagnosis
Severeacutepancreatitis
ARDS
ARF
Shock
Abdominalcompartmentsyndrome
Treatment
Intubation,tracheostomy,mechanicalventilation
Fluidresuscitationandanti-shocktherapy
Intraabdominalirrigationbylaparoscopy,continousdrainingbypersistentnegativepressure
Continuousvenovenoushighvolumehemofiltration
Anti-acidtherapyandInhibitionofpancreaticsecretion
prophylacticantibiotictheray
AdvancementoftheIllnessandOutcomeofthePatient
3rdhospitalday,developed“AbdominalCompartmentSyndrome”,andreceivedthe2ndemergentoperationasabdominalopeningandgastrointestinalfistulizationtorelievetheabdominalhighpressure
Heexperiencedmassiveabdominalhemorrhagefortwotimes,andeventhe3rdemergentoperationwasperformedforhemostasisandnecrosistissuecleaning
Variousmicrobialswererecurrentlyfoundinthecultureofthespecimenofblood,sputum,secretionofwound,thetipsofcentralvenouscatheter,andthefluiddrainedfromtheabdomen
AdvancementoftheIllnessandOutcomeofthePatient
14thday,intestinalfunctionpartiallyrecoveredandTPNwasgraduallyswitchedtoenteralnutrition
28thday,CVVHdiscontinued,urineoutputincreasedtomorethan2000ml/d.
36thday,mechanicalventilationceased
serumcreatininereturnedtonormalrangeon48thday
39thday,and57thday,receivedtwotimesofpostagestampautodermoplastyforskindefectinabdomen
161stday,afteraCTscanconfirmingthatpancreaticnecrosisandeffusionwellabsorbed,discharged
腹腔内压力的变化(膀胱测压法)
心率的变化

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