Kiselev Iu I, Markov I S
Khirurgiia (Mosk). 1990 Oct(10):122-7.
The article is the result of the joint work of a surgeon and a specialist in infectious diseases and is based on the results of treatment of 307 patients with the abdominal form of Yersinia infection Acute appendicitis was diagnosed in 73 (23.8%) of them. The abdominal form of Yersinia infection is encountered frequently among children. The authors analyse the clinical picture of acute appendicitis in patients with Yersinia infection, the time between the onset of the disease and the patient's call for the doctor, the dependence of the histologic findings in the examined removed vermiform processes on the duration of the disease, and the results of surgery. The difficulties in making the diagnosis of acute appendicitis in patients with yersinosis and concomitant mesadenitis and terminal ileitis are discussed. It is concluded that laparoscopy is advisable in doubtful clinical signs of acute appendicitis in patients with Yersinia infection due to the high frequency of destructive forms (77.9%). The average duration of in-patient treatment of persons with acute appendicitis and Yersinia infection was 4.8 days. The positive results of treatment are attributed to timely prescription of specific antibacterial therapy--the prescription of chloramphenicol from the moment that the diagnosis of yersinosis was established.
本文是一位外科医生和一位传染病专家合作的成果，基于对307例耶尔森菌感染腹部型患者的治疗结果。其中73例（23.8%）被诊断为急性阑尾炎。耶尔森菌感染腹部型在儿童中较为常见。作者分析了耶尔森菌感染患者急性阑尾炎的临床表现、发病至患者就医的时间、所检查切除的阑尾组织学结果与病程的关系以及手术结果。讨论了在耶尔森菌病合并肠系膜淋巴结炎和末端回肠炎患者中诊断急性阑尾炎的困难。得出结论，由于破坏性形式的发生率较高（77.9%），对于耶尔森菌感染且有可疑急性阑尾炎临床体征的患者，腹腔镜检查是可取的。急性阑尾炎合并耶尔森菌感染患者的平均住院治疗时间为4.8天。治疗的积极结果归因于及时开具特定的抗菌治疗——从确诊耶尔森菌病时起就使用氯霉素。
