Kunin N, Bansard J Y, Letoquart J P, Chareton B, Lebois E, La Gamma A, Mambrini A
Service de Chirurgie Générale A, Faculté des Sciences, Médicales, Université de Rennes.
J Chir (Paris). 1991 Nov;128(11):481-6.
The aim of this paper is to analyse retrospectively the data of our patients over 60 years old who had an acute peritonitis, localized or diffuse, to establish prognostic factors. They were 216 patients, who underwent surgical treatment between 1971 and 1990. We observed 243 variables and its significance using the chi 2 test. We divided our study in two stages: from 1.10.71 to 30.09.80 (group I = 93 patients) and from 1.10.80 to 31.01.90 (group II = 123 patients). Group I was composed by 51 men and 42 women with a mean age of 71.9 +/- 5.3 years. General mortality of this group was 36% (33 patients). Group II corresponded to 55 men and 68 women with a mean age of 74.26 +/- 7.1 years. Mortality was 23% (28 patients). Age, sex and associated clinical disorders were not significant on prognosis, meanwhile the clinical and biological form of presentation were not adequate to establish a severity index. The most common ethiologies were: biliar (24 patients = 26%) in group I and appendicular (41 patients = 32.2%) In group II. Significant factors on mortality rates in group II were: delay between onset of symptoms and surgical treatment (over 96 hs, p less than 0.05), generalized or purulent peritonitis operated after 96 hs from onset of the attack (p less than 0.05) and malignancy (p less than 0.01).
本文旨在回顾性分析60岁以上急性腹膜炎（局限性或弥漫性）患者的数据，以确定预后因素。共有216例患者在1971年至1990年间接受了手术治疗。我们使用卡方检验观察了243个变量及其意义。我们将研究分为两个阶段：1971年10月1日至1980年9月30日（第一组=93例患者）和1980年10月1日至1990年1月31日（第二组=123例患者）。第一组由51名男性和42名女性组成，平均年龄为71.9±5.3岁。该组的总死亡率为36%（33例患者）。第二组有55名男性和68名女性，平均年龄为74.26±7.1岁。死亡率为23%（28例患者）。年龄、性别和相关临床疾病对预后无显著影响，同时临床表现和生物学形式不足以建立严重程度指数。最常见的病因是：第一组为胆道疾病（24例患者=26%），第二组为阑尾炎（41例患者=32.2%）。第二组死亡率的显著因素为：症状发作与手术治疗之间的延迟（超过96小时，p<0.05）、发作后96小时后进行手术的全身性或脓性腹膜炎（p<0.05）和恶性肿瘤（p<0.01）。
