腹部手术后出现的复杂性腹腔感染（complicated intra-abdominal infections，cIAI）是临床常见但处理棘手的难题，需要选择合适的感染源控制手段，并合理使用抗菌药物进行治疗。针对cIAI感染源的治疗，需要贯彻损伤控制理念并建立阶梯式处理方案，首选微创改善引流或建立引流途径，可使用CT或超声导引的经皮经Trocar放置黎氏双套管冲洗引流；对于单纯改善引流无法控制感染源时则应行开腹引流；对于合并有腹腔高压的腹腔感染病人应行腹腔开放疗法。cIAI早期应根据科室致病菌流行特点选择经验性治疗用药，对于重症感染病人推荐降阶梯疗法，一旦细菌培养结果和药敏试验结果明确，则应调整抗生素。

Perioperative complicated intra-abdominal infections：Recognition and standardized therapy        WANG Ge-fei，REN Jian-an，LI Jie-shou. Clinical School of Medical College of  Nanjing University, Research Institute of General Surgery, Nanjing General Hospital of Nanjing Military Command, PLA, Nanjing 210002，China
Corresponding author：REN Jian-an，E-mail：jiananr@gmail.com
Abstract    Postoperative complicated intra-abdominal infections (cIAIs) are common but challenges in clinical practice, which need adequate source control procedure and antimicrobial therapy. Damage control and step-up approach should be set up during source control procedure of cIAIs. Initial minimally invasive intra-abdominal drainage like percutaneous drainage using a sump drain by trocar puncture should be performed. If minimally invasive drainage can't control infection，surgical drainage should be administrated. If complicated with abdominal hypertension，open abdomen should be taken into consideration. Empiric antimicrobial therapy should be initiated once a patient receives a diagnosis of an intra-abdominal infection according to epidemiological feature，followed by pathogen-directed antimicrobial therapy.