Ayandipo O O, Afuwape O O, Irabor D O, Abdurrazzaaq A I, Nwafulume N A
Department of Surgery, College of Medicine, University of Ibadan, Ibadan.; Department of Surgery, University College Hospital, Ibadan.
Department of Surgery, University College Hospital, Ibadan.
Ann Ib Postgrad Med. 2016 Jun;14(1):30-34.
Peritonitis is a life-threatening condition and requires urgent surgical management. Despite improvements in the care of patients with peritonitis, its management is still challenging and associated with significant morbidity and mortality. The aim of this study was to determine factors influencing the outcome in patients managed for peritonitis in a tertiary health institution in Nigeria.
A retrospective study involving 302 patients managed for peritonitis over a 3- year period. The biodata, clinical findings, diagnosis, pre-operative care, mode of anaesthesia, cadre of the surgeon, intraoperative findings, postoperative care, and the outcomes were retrieved from their records.
Three hundred and two patients were operated on for peritonitis during the period. The mean age of the patients was 48 ± 12 years. Twenty (6.6%) patients had other co-morbidities, with hypertension being the most frequent. Ruptured appendicitis was the most common cause of peritonitis, 83(27.5). Twenty-eight (9.2%) patients had complications, 19 patients (6.5%) required intensive care unit admission, 25 patients (8.4%) required a second exploratory laparotomy. The mortality rate was 2.4%. There was a statistically significant association between an adverse outcome and presentation with shock, anaemia, jaundice and oliguria.
The factors influencing outcome are similar to those of other Africa countries. However, the mortality rate in our study is lower. Peri-operative specific organ support and prompt surgical intervention should be instituted to improve outcome. We suggest a prospective study to elucidate the effect of these factors, and to determine the predictive power of the various scoring systems.
腹膜炎是一种危及生命的疾病，需要紧急手术治疗。尽管腹膜炎患者的护理有所改善，但其治疗仍然具有挑战性，且与显著的发病率和死亡率相关。本研究的目的是确定影响尼日利亚一家三级医疗机构中腹膜炎患者治疗结果的因素。
一项回顾性研究，涉及302例在3年期间接受腹膜炎治疗的患者。从他们的记录中检索生物数据、临床发现、诊断、术前护理、麻醉方式、外科医生职称、术中发现、术后护理及结果。
在此期间，302例患者接受了腹膜炎手术。患者的平均年龄为48±12岁。20例（6.6%）患者有其他合并症，其中高血压最为常见。阑尾破裂是腹膜炎最常见的原因，有83例（27.5%）。28例（9.2%）患者出现并发症，19例（6.5%）患者需要入住重症监护病房，25例（8.4%）患者需要进行二次剖腹探查。死亡率为2.4%。不良结局与休克、贫血、黄疸和少尿的表现之间存在统计学显著关联。
影响治疗结果的因素与其他非洲国家相似。然而，我们研究中的死亡率较低。应采取围手术期特定器官支持和及时的手术干预以改善治疗结果。我们建议进行一项前瞻性研究，以阐明这些因素的影响，并确定各种评分系统的预测能力。
