Mäkelä Jyrki T, Kiviniemi Heikki O, Laitinen Seppo T
Department of Surgery, Oulu University Hospital, P.O.Box 22, 90029 OYS, Finland.
Hepatogastroenterology. 2009 Sep-Oct;56(94-95):1382-7.
BACKGROUND/AIMS: The natural history of young patients admitted for acute diverticulitis in terms of the virulence of the disease and the need for surgical treatment has remained controversial.
One thousand eighty-one patients with acute diverticulitis admitted to our hospital from 1986 to 2006 were identified from a computer database and their clinical course was analysed Patients under or over 50 years of age were compared regarding uncomplicated and complicated diverticulitis, the number of admissions, operative procedures performed, morbidity, mortality and recurrence of diverticulitis.
Eighty-one percent of the patients aged under 50 years were admitted for uncomplicated diverticulitis, whereas 36 % of the patients aged over 50 years were admitted for complicated diverticulitis (p = 0.001). Sixty-eight percent of the patients with uncomplicated diverticulitis and 79% of those admitted for diverticular perforation were admitted only once to our hospital. The male/female ratios of patients presenting with uncomplicated diverticulitis were 114/106 for patients aged under 50 years and 181/336 for patients aged over 50 years. The respective ratios for complicated diverticulitis were 36/17 and 111/179. Overall mortality for all the admitted patients was 2%, being 0% for patients aged under 50 years, 3% for patients aged over 50 years and 5% for those admitted for diverticular perforation. Recurrent symptoms of diverticulitis developed in 34% of the patients admitted the first time for acute diverticulitis and diverticular perforation occurred in 20% of the cases.
Young patients are more often admitted for uncomplicated diverticulitis than older patients. The course of the disease in patients aged less than 50 years is not more aggressive than in older patients.
背景/目的：就疾病的严重程度及手术治疗需求而言，因急性憩室炎入院的年轻患者的自然病史一直存在争议。
从计算机数据库中识别出1986年至2006年期间我院收治的1081例急性憩室炎患者，并分析其临床病程。比较了50岁以下和50岁以上患者在单纯性和复杂性憩室炎、入院次数、所施行的手术操作、发病率、死亡率及憩室炎复发方面的情况。
50岁以下患者中81%因单纯性憩室炎入院，而50岁以上患者中36%因复杂性憩室炎入院（p = 0.001）。单纯性憩室炎患者中有68%以及因憩室穿孔入院的患者中有79%仅入院一次。50岁以下单纯性憩室炎患者的男女比例为114/106，50岁以上患者为181/336。复杂性憩室炎的相应比例分别为36/17和111/179。所有入院患者的总体死亡率为2%，50岁以下患者为0%，50岁以上患者为3%，因憩室穿孔入院的患者为5%。首次因急性憩室炎入院的患者中有34%出现憩室炎复发症状，20%的病例发生憩室穿孔。
年轻患者因单纯性憩室炎入院的情况比老年患者更常见。50岁以下患者的疾病进程并不比老年患者更具侵袭性。
