关键词: 术后腹腔感染, 治疗失败, 感染源控制, 腹腔高压, 慢性危重症

Abstract: Challenges and treatment strategies of postoperative intra-abdominal infection        WANG Ge-fei, REN Jian-an, LI Jie-shou. Department of General Surgery, the First School of Clinical Medicine, Southern Medical University and Jinling Hospital, Clinical School of Nanjing University,  Nanjing 210002, China
Corresponding author：REN Jian-an, E-mail:jan@medmail.com.cn
Abstract    Postoperative intra-abdominal infection（PIAI）is still a serious clinical challenge，and with high mortality across the global. Early diagnosis and timely therapy are the key element. Without prompt and effective treatment，PIAI will face with the threat of drug-resistant bacteria infection，chronic critical illness，intra-abdominal hypertension and multiple organ dysfunction，which will cause treatment failure. Rational application of antibiotics，prompt source control and supportive treatment including against sepsis，organ function protection and nutritional therapy are the key points of treatment. Source control is the fundamental treatment of PIAI，but the existing source control measures have not been standardized. It is recommended to implement the step-up approach of source control for PIAI. Establishment of active drainage with minimally invasive is the first step，surgical drainage should be performed when active drainage fails to control the source of infection and the open abdomen therapy should be implemented for PIAI complicated with intra-abdominal hypertension.

Key words: postoperative intra-abdominal infection, treatment failure, source control, intra-abdominal hypertension, chronic critical illness