Vasile I, Mogoş D, Păun I, Florescu M, Vîlcea D, Nedelcuţă C, Dumitrelea D, Ungureanu G
Clinica IV Chirurgie Generală, UMF Craiova.
Chirurgia (Bucur). 2000 Mar-Apr;95(2):169-77.
The authors analyze a group of 49 postoperative peritonitis, which represent 0.57% of a total of 8550 surgical interventions performed over the last 7 years and 1.19% of 4100 laparotomies carried out in an elective operation orientated general surgery department. The mortality rate was 28.57% (14 patients) among the 49 studied cases, which represents 25% of all deaths recorded in our department over the same time interval. A full account on postoperative peritonitis vital prognostic factors is given, insisting on: specific bacteriology (nosocomial infections), peculiar etiologies (10 out of 14 fatalities were originally operated on for digestive cancers), different associations of postoperative peritonitis with other infectious and noninfectious postsurgical complications (as encountered in all 14 deaths), type of postoperative peritonitis (13 death out of 14 were due to generalized peritonitis), postoperative peritonitis secondary to ignored lesions at the original operation (3 cases--3 deaths), surgical treatment limitation (late operative timing which was responsible of 9 deaths); treatment inadequacies of peritonitis and its cause--5 fatalities.
作者分析了一组49例术后腹膜炎患者，这组患者占过去7年中8550例外科手术总数的0.57%，占在一个以择期手术为主的普通外科进行的4100例剖腹手术的1.19%。在所研究的49例病例中，死亡率为28.57%（14例患者），这占同期我们科室记录的所有死亡病例的25%。文中全面阐述了术后腹膜炎的重要预后因素，着重强调了：特定的细菌学（医院感染）、特殊病因（14例死亡患者中有10例最初因消化道癌症接受手术）、术后腹膜炎与其他感染性和非感染性术后并发症的不同关联（在所有14例死亡病例中均有出现）、术后腹膜炎的类型（14例死亡中有13例死于弥漫性腹膜炎）、原手术中未被发现的病变导致的术后腹膜炎（3例——3例死亡）、手术治疗的局限性（手术时机过晚导致9例死亡）；腹膜炎及其病因的治疗不足——5例死亡。
