弥漫性粪性腹膜炎的治疗——我们能否做得更好？
Management of generalized faecal peritonitis--can we do better?
作者信息
Scholefield J H, Wyman A, Rogers K
机构信息
University Department of Surgery, Northern General Hospital, Sheffield.
出版信息
J R Soc Med. 1991 Nov;84(11):664-6. doi: 10.1177/014107689108401113.
Generalized faecal peritonitis is associated with a mortality of over 50% in most series of cases. Despite great improvements in the standards of intensive care the morbidity and mortality associated with this condition have not improved, in part due to recurrent intra-abdominal sepsis. This preliminary study investigated the role of laparotomy, repeated abdominal lavage and debridement to determine whether such a policy might lead to an improvement in outcome. Of six cases studied three had perforated diverticular disease, two had Crohn's disease. Twenty lavages were performed on these six patients who had a mean ICU stay of 8 days. Five out of the six patients left hospital and remain well, one patient died of septicaemia and pre-existing renal failure. This study found that laparotomy, repeated abdominal lavage and debridement may be effective in reducing the morbidity and mortality of generalized faecal peritonitis and further study of this technique is appropriate.
在大多数病例系列中，弥漫性粪性腹膜炎的死亡率超过50%。尽管重症监护水平有了很大提高，但与这种情况相关的发病率和死亡率并未改善，部分原因是腹腔内反复发生脓毒症。这项初步研究调查了剖腹手术、反复腹腔灌洗和清创术的作用，以确定这种治疗策略是否可能改善预后。在研究的6例病例中，3例患有憩室穿孔病，2例患有克罗恩病。对这6例平均在重症监护病房停留8天的患者进行了20次灌洗。6例患者中有5例出院且情况良好，1例患者死于败血症和先前存在的肾衰竭。本研究发现，剖腹手术、反复腹腔灌洗和清创术可能有效降低弥漫性粪性腹膜炎的发病率和死亡率，对该技术进行进一步研究是合适的。
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