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[弥漫性腹膜炎的预后因素]

[Prognostic factors in diffuse peritonitis].

作者信息

Barthlen W, Bartels H, Busch R, Siewert J R

机构信息

Chirurgische Klinik und Poliklinik, TU München, BRD.

出版信息

Langenbecks Arch Chir. 1992;377(2):89-93. doi: 10.1007/BF00184341.

Abstract

In order to evaluate their prognostic relevance for survival 46 variables were submitted to univariate as well as multivariate analysis in a group of 184 patients with diffuse peritonitis. In the univariate analysis a significant correlation with the outcome was found for the following parameters: age greater than or equal to 70 years, preexisting hepatic or cardiac disease, no eradication of the primary source of infection at first laparotomy for peritonitis, cardiovascular instability, respiratory failure, hyperbilirubinemia, thrombocytopenia, elevated serum creatinine and diminished creatinine clearance at the beginning and proof of pseudomonas aeruginosa in the peritoneal exsudate and of candida albicans in the blood culture during the course of the peritonitis. In the multivariate analysis the surgical eradication of the primary source of infection at the first laparotomy for peritonitis, serum creatinine at the beginning of peritonitis, age greater than or equal to 70 years and a preexisting hepatic disease proved to be the independent variables with significant prognostic relevance for survival of the patients.

摘要

为了评估46个变量对生存的预后相关性,对184例弥漫性腹膜炎患者进行了单变量和多变量分析。在单变量分析中,发现以下参数与结果有显著相关性:年龄大于或等于70岁、既往有肝脏或心脏疾病、在首次剖腹探查治疗腹膜炎时未根除感染的主要来源、心血管不稳定、呼吸衰竭、高胆红素血症、血小板减少、血清肌酐升高以及腹膜炎开始时肌酐清除率降低,以及在腹膜炎病程中腹膜渗出液中检测到铜绿假单胞菌和血培养中检测到白色念珠菌。在多变量分析中,首次剖腹探查治疗腹膜炎时手术根除感染的主要来源、腹膜炎开始时的血清肌酐、年龄大于或等于70岁以及既往有肝脏疾病被证明是对患者生存具有显著预后相关性的独立变量。

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