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腹部结核的急性表现与处理

Acute Presentation and Management of Abdominal Tuberculosis.

作者信息

Ahmad Qamar Ashfaq, Sarwar Muhammad Zeeshan, Fatimah Nafeesah, Ahmed Abubaker Shafiq, Changaizi Shabbar Hussain, Ayyaz Mahmood

机构信息

Department of General Surgery, Services Hospital, Lahore, Pakistan.

出版信息

J Coll Physicians Surg Pak. 2020 Feb;30(2):129-133. doi: 10.29271/jcpsp.2020.02.129.

Abstract

OBJECTIVE

To study the clinicopatholgical profile and outcomes of surgical management of abdominal tuberculosis (ATB) Study Design: Cross-sectional observational study.

PLACE AND DURATION OF STUDY

Department of Surgery, Services Hospital, Lahore, Pakistan, from May 2008 to April 2018.

METHODOLOGY

All patients who underwent emergency laparotomy during the study period due to abdominal tuberculosis, and consented to participate in the study were included. Demographic variables and type of surgical procedure performed were recorded. Patients were followed-up for histopathology, recurrence, or any anti-tuberculous therapy related complications at 1, 4, 6, and 12 months. Data were analysed using SPSS version 21.

RESULTS

Out of the 80 patients, 36 were males and 44 were females. The median age was 23.5 years (range = 11-90 years). Mean weight of the patients was 48.7 ±12.2 kg. Commonest presenting symptom was abdominal pain 72 (90%). On exploration, ileocecal region was most commonly involved segment 68 (85%). Stoma formation was the most common surgical procedure performed in 59 (73.8%) patients. Complications and mortality rate were 48 (60%) and 7 (8.7%), respectively. A significant relationship of complications was found with prolonged hospital stay (p <0.001).

CONCLUSION

Abdominal tuberculosis is a major public health concern. Vague symptoms lead to diagnostic delay so patients present late with intestinal obstruction. Ileocecal tuberculosis is the most common site of involvement.

摘要

目的

研究腹部结核(ATB)手术治疗的临床病理特征及预后。研究设计:横断面观察性研究。

研究地点和时间

2008年5月至2018年4月,巴基斯坦拉合尔服务医院外科。

方法

纳入研究期间因腹部结核接受急诊剖腹手术且同意参与研究的所有患者。记录人口统计学变量和所实施的手术类型。在1、4、6和12个月时对患者进行组织病理学、复发情况或任何抗结核治疗相关并发症的随访。使用SPSS 21版软件进行数据分析。

结果

80例患者中,男性36例,女性44例。中位年龄为23.5岁(范围=11 - 90岁)。患者平均体重为48.7±12.2千克。最常见的症状是腹痛,共72例(90%)。探查时,回盲部是最常受累的部位,共68例(85%)。造口形成是最常见的手术方式,共59例(73.8%)患者接受了该手术。并发症发生率和死亡率分别为48例(60%)和7例(8.7%)。发现并发症与住院时间延长存在显著相关性(p<0.001)。

结论

腹部结核是一个主要的公共卫生问题。症状不明确导致诊断延迟,因此患者常因肠梗阻就诊较晚。回盲部结核是最常见的受累部位。

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