Alvarez José A, Baldonedo Ricardo F, Bear Isabel G, Otero Jorge, Pire Gerardo, Alvarez Paloma, Jorge José I
Service of General Surgery, Hospital San Agustín, Avilés, Spain.
Int Surg. 2009 Jul-Sep;94(3):240-8.
The aim of this study was to assess the outcomes after treatment of patients with this condition and to identify prognostic factors of morbidity and mortality. From 1986 to 2005, the charts of 114 consecutive patients who were treated for perforated sigmoid diverticulitis were retrospectively reviewed. Thirty-three patients (28.9%) were treated conservatively, and 81 (71.1%) underwent surgery. Postoperative major morbidity and mortality rates were 35.8% and 6.2%, respectively. Age > 70 years, female sex, associated diseases, low serum albumin level, high American Society of Anesthesiologists class, and Mannheim Peritonitis Index score of 21 or more were factors linked with a poor outcome. Perforated diverticulitis carries substantial morbidity and occasional mortality. To achieve improvements in outcomes, the surgical procedure should be chosen on the basis of the presence of prognostic factors. Moreover, intensive treatment after surgery in patients with risk factors is recommended.
本研究的目的是评估患有这种疾病的患者经治疗后的结果，并确定发病和死亡的预后因素。1986年至2005年，对114例连续接受乙状结肠憩室穿孔治疗的患者病历进行回顾性分析。33例患者（28.9%）接受保守治疗，81例（71.1%）接受手术治疗。术后主要发病率和死亡率分别为35.8%和6.2%。年龄>70岁、女性、合并疾病、血清白蛋白水平低、美国麻醉医师协会分级高以及曼海姆腹膜炎指数评分21分及以上是与不良预后相关的因素。憩室穿孔具有较高的发病率和偶发死亡率。为改善治疗结果，应根据预后因素选择手术方式。此外，建议对有危险因素的患者术后进行强化治疗。
