免疫抑制疗法成功治疗1例左侧半结肠切除术后新型冠状病毒感染重症化脓性并发症

G. G. Nakopiya, S. A. Danilov, Yu. V. Radionov, Yu. V. Grebtsov, E. V. Pykhtin, N. Yu. Kohanenko, Yu. N. Ulyanov, I. A. Nechay
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引用次数: 0

摘要

术后第7天,患者被确诊为新型冠状病毒感染。从病毒性疾病发病的第5天和手术后的第12天,出现了“细胞因子风暴”的迹象,肺损伤的体积从6%增加到50%,呼吸衰竭的现象增加。给予免疫抑制治疗(高剂量糖皮质激素、白细胞介素阻滞剂)。病情稳定下来。术后第20天、诊断为新型冠状病毒感染后第13天出现腹膜炎征象,无原发灶的广泛性浆液性腹膜炎需行腹腔镜环卫及腹腔引流。在半结肠切除术后第26天,冠状病毒感染发生后第19天,对左侧腹膜后痰进行腹膜外切开。在半结肠切除术后第61天,冠状病毒感染后第68天,对右侧腹膜后间隙的痰行腹膜外切开。第78天,他出院了,情况令人满意。
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Successful treatment of a patient with a severe course of a new coronavirus infection and purulent complications after left-sided hemicolectomy under the immunosuppressive therapy
On the seventh day after the operation, the patient was diagnosed with the new coronavirus infection. On the fifth day from the onset of the viral disease and on the 12th day after the operation, the signs of a “cytokine storm” were appeared, the volume of lung damage increased from 6 to 50 %, and the phenomena of respiratory failure increased. Immunosuppressive therapy (high doses of glucocorticoids, interleukin blockers) was prescribed. The condition was stabilized. On the 20th day after the operation and the 13th day from the start of the diagnosis of the new coronavirus infection, there were signs of peritonitis, which required laparoscopic sanitation and drainage of the abdominal cavity for widespread serous peritonitis without a primary focus. On the 26th day after hemicolectomy and the 19th day from the onset of coronavirus infection, the extraperitoneal opening of the retroperitoneal phlegmon on the left was performed. On the 61st day after hemicolectomy and the 68th day from the onset of coronavirus infection, the extraperitoneal opening of the phlegmon of the retroperitoneal space on the right was performed. On the 78th day, he was discharged from the hospital in a satisfactory condition.
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CiteScore
0.30
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0.00%
发文量
40
审稿时长
8 weeks
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