进一步提高普通外科危重症病人诊疗水平OA

Advances in the diagnosis and treatment of critical surgical patients stem from the integration of critical care medicine,general surgery,and multidisciplinary collaboration.Progress in Intensive Care Medicine(ICU)includes fluid resuscitation,mechanical ventilation,continuous renal replacement therapy,extracorporeal membrane oxygenation and point-of-care ultrasound.The De-escalation concept helps avoid complications such as ventilator-associated pneumonia and catheter-related infections from prolonged support care.The widespread application of damage control surgery has significantly improved the survival rate of critically ill surgical patients.Surgical interventions for critically ill patients encompass laparotomy,percutaneous drainage,removal or replacement of drainage tubes,bedside debridement and hemostasis,open abdomen therapy,and vascular interventional procedures.Planned laparotomy and staged surgeries are particularly suitable for critically ill abdominal surgery patients whose conditions remain unstable.Surgeons should select the appropriate timing and surgical approaches based on the patient's condition.The key to treating surgical critically ill patients lies in the active cooperation of surgeons and ICU physicians.Acute care surgery has developed,and acute care surgeons are trained to specially treat surgical critical illness,trauma and emergency surgical patients.This integrated model has effectively enhanced surgeons' ability to treat critically ill surgical patients and is worthy of promotion.