Werbin N, Kashtan H, Wasserman I, Wiznitzer T
Department of Surgery A, Ichilov Hospital, Tel-Aviv Medical Center, Israel.
Can J Surg. 1990 Apr;33(2):143-4.
Acute perforation of a duodenal ulcer in a patient over of 70 years of age is associated with a high death rate. During a 10-year period, 35 such patients were operated on; in all omentopexy was performed. Two courses of the disease were observed: the first (19 patients) was defined by acute disease of less than 24 hours' duration preceding surgery; the second (16 patients) was of longer duration, starting with various abdominal complaints and presenting more severely only after the first 24 hours. Postoperative death rates were 0% in the first group and 50% in the second. Other factors that were studied, including diabetes mellitus, presence of concomitant malignant diseases and intake of ulcerogenic drugs, had no significant effect on the outcome in these patients.
70岁以上患者十二指肠溃疡急性穿孔的死亡率很高。在10年期间，对35例此类患者进行了手术；均施行网膜固定术。观察到两种病程：第一种（19例患者）的特点是手术前急性病期短于24小时；第二种（16例患者）病程较长，始于各种腹部不适，仅在最初24小时后病情更严重。第一组术后死亡率为0%，第二组为50%。所研究的其他因素，包括糖尿病、合并恶性疾病的存在以及致溃疡药物的摄入，对这些患者的预后均无显著影响。
