Karmacharya B, Sharma V K
Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal.
Kathmandu Univ Med J (KUMJ). 2006 Jan-Mar;4(1):22-4.
To determine the demographic characteristics, clinical features, operative findings and postoperative complications in patients operated for typhoid enteric perforation.
A retrospective study was carried out in the Department of General Surgery, Bir Hospital since 2002 to April 2004. Among 189 patients who underwent laparotomy for hollow viscus perforation in two years, ileal perforation was found in 102 patients.
The sex ratio of the patients was 4.66:1, in favor of male, with age range of 14-78 years and mean age 28.35 years. Most of the patients (80.39 %) presented with history of fever for two weeks. Half of the patients presented within 24 hours of onset of generalized abdominal pain. Majority (65.67%) had a solitary perforation on the antimesenteric border of terminal ileum. Eighty one percent of patients had trimming of the ulcer margins and primary closure. Complications included wound infection (35.3%), wound dehiscence (17.6%), fecal fistula (7.84%) and hospital mortality (6.86%).
Typhoid ulcer perforation is common among developing nations, including Nepal. Postoperative complications following surgical management of perforation are high and increases mortality.
确定接受伤寒肠穿孔手术患者的人口统计学特征、临床特征、手术发现及术后并发症。
自2002年至2004年4月在比尔医院普通外科进行一项回顾性研究。在两年内接受剖腹探查治疗中空脏器穿孔的189例患者中，发现102例为回肠穿孔。
患者性别比为4.66:1，男性居多，年龄范围为14 - 78岁，平均年龄28.35岁。大多数患者（80.39%）有两周发热史。半数患者在全腹痛发作24小时内就诊。多数（65.67%）在回肠末端对系膜缘有单个穿孔。81%的患者进行了溃疡边缘修整及一期缝合。并发症包括伤口感染（35.3%）、伤口裂开（17.）、粪瘘（7.84%）及医院死亡率（6.86%）。
伤寒溃疡穿孔在包括尼泊尔在内的发展中国家很常见。穿孔手术治疗后的术后并发症发生率高且增加死亡率。
