O'Riordain D S, O'Dwyer P J, O'Higgins N J
Department of Surgery, St. Vincent's Hospital, Ireland.
J R Coll Surg Edinb. 1990 Apr;35(2):93-4.
To examine the mortality and morbidity associated with perforated duodenal ulcer in patients 70 years or older a review of those admitted between 1978 and 1987 was undertaken. There were 33 patients, three in whom the diagnosis was made at post-mortem examination. Two patients were considered unfit for surgery and were treated conservatively while 28 were treated by operation. There were three postoperative deaths giving an operative mortality rate of 11.7%. Overall mortality rate from perforated duodenal ulcer in the series was 24%. Serious postoperative morbidity occurred in 72% of patients surviving operation. The occurrence of morbidity correlated positively with the time interval between symptoms of perforation and surgery although statistical significance was not shown. Perforated duodenal ulcer is associated with a high mortality and morbidity in the elderly. Efforts to reduce mortality and morbidity should be aimed at accurate diagnosis and early surgical intervention.
为研究70岁及以上十二指肠溃疡穿孔患者的死亡率和发病率，我们回顾了1978年至1987年间收治的此类患者。共有33例患者，其中3例在尸检时确诊。2例患者被认为不宜手术，接受了保守治疗，而28例接受了手术治疗。术后有3例死亡，手术死亡率为11.7%。该系列中十二指肠溃疡穿孔的总体死亡率为24%。术后存活的患者中有72%发生了严重的术后并发症。并发症的发生与穿孔症状出现至手术的时间间隔呈正相关，尽管未显示出统计学意义。十二指肠溃疡穿孔在老年人中与高死亡率和高发病率相关。降低死亡率和发病率的努力应旨在准确诊断和早期手术干预。
