Lozon A A, Duff J H
Can J Surg. 1976 Jan;19(1):48-51.
Acute perforation of the colon causes fecal peritonitis, which is associated with high rates of morbidity and mortality. Findings in 78 patients with perforation of the colon showed that the commonest causative condition was diverticulitis (in 42%) and that the commonest site was the sigmoid colon (in 65%). The overall mortality in this series was 49%, most of the deaths being due to peritonitis; the extent of anatomic spread of peritonitis was a major factor. The form of treatment was also a factor in mortality: mortality was lowest in patients treated by diversionary colostomy (only 38%) and highest in those treated by exteriorization of perforation (71%) and in those not treated operatively (71%). With respect to postoperative complications in patients who underwent operation, wound infection and pulmonary abnormalities each occurred in 50%. This review suggests that current methods of management of patients with perforation of the colon are less than satisfactory.
结肠急性穿孔会导致粪性腹膜炎，其与高发病率和死亡率相关。对78例结肠穿孔患者的研究结果显示，最常见的致病情况是憩室炎（42%），最常见的发病部位是乙状结肠（65%）。该系列患者的总体死亡率为49%，大多数死亡是由腹膜炎导致的；腹膜炎解剖扩散的程度是一个主要因素。治疗方式也是影响死亡率的一个因素：采用转流性结肠造口术治疗的患者死亡率最低（仅38%），穿孔外置术治疗的患者死亡率最高（71%），未接受手术治疗的患者死亡率也最高（71%）。关于接受手术患者的术后并发症，伤口感染和肺部异常的发生率均为50%。本综述表明，目前结肠穿孔患者的治疗方法并不令人满意。
