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手术治疗的穿孔性消化性溃疡患者死亡风险因素的评估

Evaluation of risk factors for mortality in surgically treated perforated peptic ulcer.

作者信息

Sillakivi T, Lang A, Tein A, Peetsalu A

机构信息

Department of Surgery, University of Tartu, Puusepa 8, 51014 Tartu, Estonia.

出版信息

Hepatogastroenterology. 2000 Nov-Dec;47(36):1765-8.

Abstract

BACKGROUND/AIMS: The aim of our study was to evaluate complications and possible risk factors for mortality in perforated peptic ulcer patients with a special reference to the fact whether definitive or non-definitive operation was performed.

METHODOLOGY

All 394 patients (mean age: 45.5 years; range: 15-93) from Tartu county hospitalized for PPU at Tartu University Clinic in the period 1978-97 were included in a retrospective study.

RESULTS

Twenty-two patients (5.6%) of 394 died. In 73 patients 93 concomitant diseases (mortality 19.2%) and in 81 patients 114 complications were observed. There were 245 non-definitive operations and 141 definitive operations with a mortality rate of 7.3% and 1.4%, respectively. Univariate logistic regression analysis of 386 operatively treated patients revealed that age > or = 65 years, concomitant diseases, treatment delay > or = 12 hours, female sex and non-definitive operations were significantly associated with mortality. However, multivariate analysis showed that only age > or = 65 years and concomitant diseases were independent predictors of mortality.

CONCLUSIONS

Patients' high age and presence of concomitant diseases were related to lethal outcome after surgical procedure performed for perforated peptic ulcer. The result did not depend on the fact whether definitive or non-definitive operation was applied.

摘要

背景/目的:我们研究的目的是评估穿孔性消化性溃疡患者的并发症及可能的死亡风险因素,特别关注是否进行了确定性或非确定性手术这一事实。

方法

对1978年至1997年间在塔尔图大学诊所因穿孔性消化性溃疡住院的塔尔图县的所有394例患者(平均年龄:45.5岁;范围:15 - 93岁)进行回顾性研究。

结果

394例患者中有22例(5.6%)死亡。73例患者有93种合并疾病(死亡率19.2%),81例患者出现114种并发症。有245例非确定性手术和141例确定性手术,死亡率分别为7.3%和1.4%。对386例接受手术治疗的患者进行单因素逻辑回归分析显示,年龄≥65岁、合并疾病、治疗延迟≥12小时、女性以及非确定性手术与死亡率显著相关。然而,多因素分析表明,只有年龄≥65岁和合并疾病是死亡率的独立预测因素。

结论

穿孔性消化性溃疡手术后患者的高龄和合并疾病与致命结局相关。结果并不取决于是否应用了确定性或非确定性手术。

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