Nilsson L O
Acta Chir Scand. 1976;142(6):467-9.
Previous reports show evidence that perforation of the sigmoid colon with diffuse peritonitis, when conventionally treated (i.e. by suture, drainage, and proximal defunctioning colostomy) is associated with a high mortality. Recent investigations, however, indicate that the mortality can be lowered considerably if acute resection or exteriorization of the affected segment of the bowel is performed. Fifteen patients with perforated lesions in the sigmoid colon associated with diffuse peritonitis were treated with drainage and right transverse colostomy during the 10-year period 1963-72 with five deaths. In comparison, during the last years, ten patients with perforation and diffuse peritonitis were treated with acute resection or exteriorization of the affected segment of the bowel without any mortality. Though the two patient series are not completely comparable, the results imply that removal or exteriorization of the affected bowel is to be preferred in the surgical treatment of most perforated lesions in the sigmoid colon, even if the perforation is associated with diffuse peritonitis.
以往的报告显示，乙状结肠穿孔伴弥漫性腹膜炎患者，采用传统治疗方法（即缝合、引流及近端结肠造口失功术）时，死亡率很高。然而，近期研究表明，若对受累肠段进行急性切除或外置术，死亡率可大幅降低。1963年至1972年的10年间，15例乙状结肠穿孔伴弥漫性腹膜炎患者接受了引流及右半横结肠造口术治疗，其中5例死亡。相比之下，在过去几年中，10例穿孔伴弥漫性腹膜炎患者接受了受累肠段急性切除或外置术治疗，无一例死亡。尽管这两组患者并不完全具有可比性，但结果表明，在大多数乙状结肠穿孔性病变的手术治疗中，即使穿孔伴有弥漫性腹膜炎，切除或外置受累肠段仍是首选方法。
