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[重症急性阑尾炎的免疫学和细菌学研究。诊断与治疗考量]

[Immunologic and bacteriologic study of severe acute appendicitis. Diagnostics and therapeutic considerations].

作者信息

Voiculescu D, Palade R

机构信息

Clinica Chirurgie I, Spitalul Universitar de Urgenţă Bucureşti.

出版信息

Chirurgia (Bucur). 2007 May-Jun;102(3):271-6.

Abstract

Acute appendicitis remains an up to date issue, being the most frequent cause of surgical acute abdomen round the globe. The complications that occurs creates important therapeutically difficulties. The study, based on 114 cases, had analyzed not only the pathogen flora (type, association, frequency of certain germs, the relation between them and different pathological lesion), but also the immune response of the organism to septic aggression. The microbiological tests from the lumen and bont of the appendix and also from peritoneal cavity showed monobacterial infection (11%) and pluribacterial infection (89%). Association between aerobes and anaerobes germs was identified in 85%. The most frequent germs identified were E. coli (87%) and Bacteroides (55%). We didn't identify germs with particular pathogenesis and the immune response had no malfunction. We can conclude that time factor is the main element in constituting of complications during acute appendicitis. A late diagnosis and also a late surgical intervention are the bases for the gravity of the pathogenic process.

摘要

急性阑尾炎仍然是一个与时俱进的问题,是全球范围内外科急性腹痛最常见的原因。所发生的并发症造成了重要的治疗困难。该研究基于114例病例,不仅分析了病原菌菌群(类型、组合、某些细菌的频率、它们之间的关系以及不同的病理病变),还分析了机体对脓毒症侵袭的免疫反应。阑尾腔和阑尾尖端以及腹腔的微生物检测显示单菌感染(11%)和多菌感染(89%)。85%的病例中发现需氧菌和厌氧菌之间存在组合。最常见的细菌是大肠杆菌(87%)和拟杆菌(55%)。我们未发现具有特殊发病机制的细菌,且免疫反应没有故障。我们可以得出结论,时间因素是急性阑尾炎并发症形成的主要因素。诊断延迟以及手术干预延迟是致病过程严重程度的基础。

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