What are the treatments for peritonitis

Peritonitis is a type of abdominal disease. The main causes of this disease are viral infection, trauma, damage caused by chemicals, etc. This is a relatively serious disease, which includes primary peritonitis and secondary peritonitis, and secondary peritonitis occurs more frequently. After the onset of peritonitis, it will indirectly cause infection and damage to other abdominal organs. People with this disease may experience fever, vomiting, and some complications, such as abdominal swelling, low blood pressure, etc. Life-threatening symptoms should be treated in time. The following will introduce the treatment of peritonitis.

1. Non-surgical treatment

1. Body Position

When there is no shock, the patient should take a semi-recumbent position to facilitate drainage. When in a semi-recumbent position, you should frequently move your lower limbs and change the pressure points to prevent venous thrombosis and pressure sores.

2. Fasting

Patients with gastrointestinal perforation must absolutely fast to reduce continued leakage of gastrointestinal contents.

3. Gastrointestinal decompression

It can reduce gastrointestinal distension, improve gastrointestinal wall blood circulation, and reduce the leakage of gastrointestinal contents into the abdominal cavity through the rupture.

4. Intravenous infusion of crystalloid colloid solution

Fasting patients with peritonitis must receive fluid infusion to correct water, electrolyte, and acid-base imbalances. Patients with severe exhaustion should receive more blood, plasma, and albumin to replenish the protein lost due to peritoneal exudation and prevent hypoproteinemia and anemia.

5. Supplement calories and nutrition

Peritonitis requires a large amount of calories and nutrition to meet its needs. Compound amino acid solution should be given to reduce the consumption of protein in the body. Deep vein high nutrition therapy should be considered for patients who cannot eat for a long time.

6. Application of antibiotics

Large doses of broad-spectrum antibiotics should be used in the early stage and then adjusted according to the results of bacterial culture. Choose sensitive antibiotics, such as chloramphenicol, clindamycin, metronidazole, gentamicin, ampicillin, etc. For patients with Gram-negative bacterial sepsis, third-generation cephalosporins, such as Bilirubin, can be used.

7. Analgesia

For patients whose diagnosis and treatment have been determined, use pethidine or morphine to relieve pain. However, if the diagnosis has not been confirmed and the patient still needs observation, it is not advisable to use painkillers to avoid masking the condition.

2. Surgical treatment

1. Lesion treatment

The earlier the infection source is cleared surgically, the better the patient's prognosis. In principle, the surgical incision should be as close to the lesion as possible. A straight incision is preferred to facilitate upward and downward extension and to facilitate changes in surgical methods.

2. Clean the abdominal cavity

After eliminating the cause of the disease, the pus in the abdominal cavity should be sucked out as much as possible, and the food and residue, feces, foreign objects, etc. in the abdominal cavity should be cleared out.

3. Drainage

The purpose is to allow the exudate that continues to be produced in the abdominal cavity to be discharged from the body through drainage so that the remaining inflammation can be controlled, limited and eliminated. Prevent the occurrence of abdominal abscesses. After surgery for diffuse peritonitis, drainage is generally not required as long as the area is cleaned thoroughly. However, abdominal drainage must be placed in the following circumstances: ① The necrotic lesion cannot be completely removed or a large amount of necrotic material cannot be removed; ② There is a lot of exudate or bleeding at the surgical site; ③ A localized abscess has formed.

Prognosis

Due to advances in diagnosis and treatment, the prognosis of acute peritonitis has improved compared with the past, but the mortality rate is still between 5% and 10%. The incidence of primary peritonitis in patients with cirrhosis and ascites is as high as 40%. Delayed diagnosis and late treatment will have a poor prognosis for children, the elderly, and those with heart, lung, kidney diseases and diabetes.

prevention

Early and appropriate treatment of intra-abdominal inflammatory diseases that may cause peritonitis is a fundamental measure to prevent peritonitis. Any abdominal surgery, including abdominal puncture, should be performed strictly according to aseptic techniques. Oral antibiotics should be given before intestinal surgery to reduce the occurrence of peritonitis.