ObjectiveTo explore the clinical efficacy and application significance of continuous irrigation and drainage for intestinal fistula combined with abdominal infection.MethodsClinical data of 62 patients with intestinafistula combined with abdominal infection admitted by Department of General Surgery of The 940th Hospital of The People’s Liberation Army Joint Service Support Force from March 2012 to March 2017 were retrospectively analyzed. All patients were treated with continuous abdominal flushing and drainage after emergency surgery. The duration of peritoneal flushing, antibiotic use, blood picture recovery, fistula healing, and total hospitalization were summarized.ResultsAll 62 patients were treated successfully without death or septic shock. Among them, 49 cases of intestinal fistula were treated with continuous abdominal flushing and drainage, and 13 cases of intestinal fistula were treated by continuous flushing and drainage of the abdominal cavity. There were 6 cases of abdominal abscess, 5 cases of incision infection, 5 cases of pleural effusion, and 2 cases of pulmonary infection after surgery. The continuous abdominal cavity washing time was (45±21) d, antibiotic use time was (14±7) d, blood image recovery time was (16±8) d, the healing time of fistula was (47±24) d, total length of hospital stay was (56±27) d.ConclusionsFor intestinal fistula combined with abdominal cavity infection, peritoneal continuous flushing and drainage is related with curative effect, high cure rate, fewer complications, simple washing equipment, simple technology, lower cost, and convenient nursing, which can create a good condition for the complexity or refractory patients with intestinal fistula, and has a high clinical application significance.
ObjectiveTo understand the research progress of Triggering Receptor Expressed on Myeloid Cells-1 (TREM-1) in abdominal cavity infection and sepsis. MethodsThe relevant literatures at home and abroad in recent years regarding the research on the role of TREM-1 in abdominal cavity infection and sepsis were retrieved and reviewed. ResultsRecent studies have focused on the key role of TREM-1 in abdominal infection and sepsis. TREM-1 is a pattern recognition receptor, which rapidly upregulated under inflammatory stimulation, forming a positive feedback loop that significantly amplifies the immune response. Its activation can trigger the cascaded release of a large number of proinflammatory factors and chemokines, exacerbating the inflammatory storm; at the same time, excessive activation of the pathway is regarded as the core driving mechanism for the progression of sepsis and even septic shock. ConclusionsThe TREM-1-mediated amplification effect of inflammatory cascades has been identified as a key link in immune imbalance in infectious diseases such as sepsis and abdominal infections. Further clarification of the expression dynamics of TREM-1 under different infectious conditions and the regulatory mechanisms of its signaling pathways is expected to provide new biomarkers for the clinical diagnosis and prognostic evaluation of infectious diseases, as well as theoretical basis for targeted intervention strategies and new drug development, thereby promoting the establishment and optimization of precise diagnosis and treatment regimens.