发展中国家三级外科服务中的再次剖腹手术
Repeat laparotomy in a developing world tertiary level surgical service.
作者信息
Scriba Matthias F, Laing Grant L, Bruce John L, Clarke Damian L
机构信息
Department of Surgery, Pietermaritzburg Hospital Complex, University of KwaZulu Natal, Townbush Road, Pietermaritzburg, KwaZulu-Natal, South Africa.
Department of Surgery, Pietermaritzburg Hospital Complex, University of KwaZulu Natal, Townbush Road, Pietermaritzburg, KwaZulu-Natal, South Africa.
出版信息
Am J Surg. 2015 Oct;210(4):755-8. doi: 10.1016/j.amjsurg.2015.03.024. Epub 2015 Jun 1.
BACKGROUND
Repeat laparotomy is associated with significant morbidity and mortality; however, developing world data are scarce. This study reviews the spectrum and outcomes of relaparotomy in a developing world setting.
METHODS
Prospectively collected data from adult patients needing repeat laparotomy over an 18-month period were analyzed.
RESULTS
Relaparotomy rate was 24% and average age was 38 years with a male predominance (70%). Appendicitis and trauma were the most common diagnoses. Planned relaparotomy rate was high (41%); however, negative relaparotomy rate was only 9%. Need for intensive care unit admission (51%) and morbidity rate (64%) were both high, but overall mortality rate was 14%. Patients requiring multiple relaparotomies had further worsened outcomes.
CONCLUSIONS
The need for repeat laparotomy in the developing world is high and it is associated with significant morbidity and need for intensive care unit admission. However, mortality rates and negative repeat laparotomy rates were low.
背景
再次剖腹手术与显著的发病率和死亡率相关；然而，发展中国家的数据稀缺。本研究回顾了在发展中国家环境下再次剖腹手术的范围和结果。
方法
分析了在18个月期间前瞻性收集的需要再次剖腹手术的成年患者的数据。
结果
再次剖腹手术率为24%，平均年龄为38岁，男性占主导（70%）。阑尾炎和创伤是最常见的诊断。计划性再次剖腹手术率较高（41%）；然而，阴性再次剖腹手术率仅为9%。入住重症监护病房的需求（51%）和发病率（64%）都很高，但总体死亡率为14%。需要多次再次剖腹手术的患者预后进一步恶化。
结论
发展中国家对再次剖腹手术的需求很高，并且与显著的发病率以及入住重症监护病房的需求相关。然而，死亡率和阴性再次剖腹手术率较低。
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