Barras J P
Chirurgische Klinik, Kantonsspital, Aarau.
Ther Umsch. 1990 Jul;47(7):569-73.
50% of the patients admitted for acute abdominal pain have an infectious intra-abdominal disease, most of them an appendicitis, a cholecystitis or a diverticulitis. These infectious diseases are due to a noninfectious lesion of the wall of an intestinal organ. The defense mechanism and the bacterial synergism limit the number, nature and local extension of the multiple micro-organism, producing a strong selection. For the treatment, antibiotics play an important adjuvant role. The main question in all cases is to determine if the cure of the wall lesion is necessary. Furthermore, it is important to choose the ideal time to do it, according to the extension of the lesion, the immunocompetence and the physiological state of the patient. The advantages and inconveniences of an early or late operation have to be weighted. Some special aspects of appendicitis, cholecystitis and diverticulitis are discussed.
因急性腹痛入院的患者中,50%患有腹内感染性疾病,其中大多数为阑尾炎、胆囊炎或憩室炎。这些感染性疾病是由肠道器官壁的非感染性病变引起的。防御机制和细菌协同作用限制了多种微生物的数量、种类和局部扩散,产生了强烈的筛选作用。在治疗方面,抗生素起着重要的辅助作用。所有病例中的主要问题是确定是否有必要治愈肠壁病变。此外,根据病变的范围、患者的免疫能力和生理状态选择理想的治疗时间也很重要。必须权衡早期或晚期手术的利弊。文中还讨论了阑尾炎、胆囊炎和憩室炎的一些特殊方面。