腹部手术后破伤风:范围回顾

Gonçalves Giuliana Fulco, Miranda Italo Barros, do Rêgo Amália Cinthia Meneses, Araújo-Filho* Irami
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摘要

术后破伤风是一种罕见的,经常被遗忘,但潜在致命的腹部手术并发症。本文的目的是回顾现有的关于腹部手术后破伤风的文献,包括其发病率、危险因素、临床特征、处理和结果。采用相关关键词(“破伤风”、“腹部手术”、“术后”)综合检索PubMed、Embase、Scopus、Lilacs、谷歌Scholar数据库,共筛选出1.182篇文献进行综述,其中11篇入选。腹部手术后破伤风的发生率很低,文献中仅有少数病例报道。大多数病例发生在有慢性酒精中毒、糖尿病和营养不良等危险因素的患者中。术后破伤风的临床表现是多种多样的,从轻微的症状如肌肉僵硬和痉挛到严重的症状如呼吸衰竭和心脏骤停。术后破伤风的诊断主要是临床诊断,并以特征性症状和体征为基础。治疗包括及时给予破伤风免疫球蛋白,伤口清创和支持性护理。总之,腹部手术后破伤风是一种罕见但严重的并发症,需要立即识别和处理。临床医生应了解破伤风的危险因素,并对高危患者采取适当的预防措施,如术前接种疫苗。
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Postoperative Tetanus in Abdominal Surgery: Scope Review
Postoperative tetanus is a rare, often forgotten, but potentially fatal complication of abdominal surgery. The purpose of this paper is to review the available literature on postoperative tetanus following abdominal surgery, including its incidence, risk factors, clinical features, management, and outcomes. A comprehensive search of the PubMed, Embase, Scopus, Lilacs, and Google Scholar databases was conducted using relevant keywords (“Tetanus,” “abdominal surgery,” “Postoperative”), and a total of 1.182 articles were identified for review, with 11 being selected. The incidence of postoperative tetanus following abdominal surgery is very low, with only a few case reports published in the literature. Most cases occurred in patients with risk factors such as chronic alcoholism, diabetes, and malnutrition. The clinical presentation of postoperative tetanus can be variable, ranging from mild symptoms such as muscle stiffness and spasm to severe features such as respiratory failure and cardiac arrest. The diagnosis of postoperative tetanus is primarily clinical and is based on characteristic symptoms and signs. Treatment involves prompt administration of tetanus immunoglobulin, wound debridement, and supportive care. In conclusion, postoperative tetanus following abdominal surgery is a rare but severe complication that requires immediate recognition and management. Clinicians should be aware of the risk factors for tetanus and take appropriate preventive measures, such as preoperative vaccination, in high-risk patients.
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