Corfitsen M T, Hansen C P, Christensen T H, Kaae H H
Department of Urology D, Rigshospitalet, University Hospital, Copenhagen, Denmark.
Eur J Surg. 1992 Jan;158(1):51-3.
The results of surgery in 14 immunosuppressed patients with 17 anorectal abscesses are presented. Abscess incision was followed by almost immediate relief of pain. Healing was obtained in 15 cases, but two patients died of causes unrelated to surgery. Symptoms, therapeutic possibilities and prognosis are discussed. The authors conclude that surgery should be performed in all cases to prevent development of septicemia. Fluctuation should not be awaited, but surgery should be minimized if granulocyte and platelet counts are low. Each patient must be managed individually, according to the nature of malignant disease, general state of health and degree of immunosuppression. Antibiotic cover is important, and primary closure of the abscess cavity should never be attempted.
本文介绍了14例免疫抑制患者17处肛门直肠脓肿的手术结果。脓肿切开后疼痛几乎立即缓解。15例患者伤口愈合,但有2例患者死于与手术无关的原因。文中讨论了症状、治疗方法及预后。作者得出结论,所有病例均应进行手术以预防败血症的发生。不应等待脓肿出现波动感,但如果粒细胞和血小板计数较低,则应尽量减少手术操作。必须根据恶性疾病的性质、总体健康状况和免疫抑制程度对每位患者进行个体化治疗。抗生素覆盖很重要,绝不应尝试对脓肿腔进行一期缝合。