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本文引用的文献

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Patient outcomes and prognostic factors associated with colonic perforation surgery: a retrospective study.结肠穿孔手术相关的患者预后及预后因素:一项回顾性研究。
J Yeungnam Med Sci. 2022 Apr;39(2):133-140. doi: 10.12701/yujm.2021.01445. Epub 2021 Oct 29.
2
Examination of food consumption in United States adults and the prevalence of inflammatory bowel disease using National Health Interview Survey 2015.利用 2015 年国家健康访谈调查研究美国成年人的食物消费和炎症性肠病的流行情况。
PLoS One. 2020 Apr 23;15(4):e0232157. doi: 10.1371/journal.pone.0232157. eCollection 2020.
3
Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines.术中手术部位感染控制与预防:WSES 腹腔感染指南的立场文件和未来增编。
World J Emerg Surg. 2020 Feb 10;15(1):10. doi: 10.1186/s13017-020-0288-4.
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Secondary peritonitis: principles of diagnosis and intervention.继发性腹膜炎:诊断和干预原则。
BMJ. 2018 Jun 18;361:k1407. doi: 10.1136/bmj.k1407.
5
Derivation and validation of a prognostic model for postoperative risk stratification of critically ill patients with faecal peritonitis.粪便性腹膜炎重症患者术后风险分层预后模型的推导与验证
Ann Intensive Care. 2017 Sep 12;7(1):96. doi: 10.1186/s13613-017-0314-1.
6
Improving results of surgery for fecal peritonitis due to perforated colorectal disease: A single center experience.提高穿孔性结直肠疾病导致的粪性腹膜炎手术疗效:单中心经验。
Int J Surg. 2016 Jan;25:91-7. doi: 10.1016/j.ijsu.2015.11.028. Epub 2015 Nov 27.
7
Prospective analysis of indications and early complications of emergency temporary loop ileostomies for perforation peritonitis.穿孔性腹膜炎急诊临时回肠造口术适应证及早期并发症的前瞻性分析
Ann Gastroenterol. 2015 Jan-Mar;28(1):135-140.
8
An audit of secondary peritonitis at a tertiary care university hospital of Sindh, Pakistan.巴基斯坦信德省一所三级教学医院的继发性腹膜炎审核。
World J Emerg Surg. 2012 Mar 16;7:6. doi: 10.1186/1749-7922-7-6.
9
Gastrointestinal perforation and the acute abdomen.胃肠道穿孔与急腹症。
Med Clin North Am. 2008 May;92(3):599-625, viii-ix. doi: 10.1016/j.mcna.2007.12.004.
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Peptic ulcer disease.消化性溃疡病
Am Fam Physician. 2007 Oct 1;76(7):1005-12.

三级护理医院治疗胃肠道穿孔继发腹膜炎一年的经验:一项回顾性分析

One Year of Experience Managing Peritonitis Secondary to Gastrointestinal Perforation at a Tertiary Care Hospital: A Retrospective Analysis.

作者信息

Shahid Muhammad Hasaan, Khan Faisal I, Askri Zain, Asad Arslan, Alam M Azhar, Ali Danish, Saeed Rabia, Jamal Aun, Fatima Tauseef, Afzal M Farooq

机构信息

General Surgery, Lahore General Hospital, Lahore, PAK.

General Surgery, Mansoorah Teaching Hospital, Lahore, PAK.

出版信息

Cureus. 2022 Apr 8;14(4):e23966. doi: 10.7759/cureus.23966. eCollection 2022 Apr.

DOI:10.7759/cureus.23966
PMID:35541300
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9081317/
Abstract

Introduction Peritonitis secondary to gastrointestinal perforation causes high morbidity and mortality rates in the emergency department with an immediate need for surgical intervention. Despite improved surgical management procedures, patients are still suffering from gastrointestinal leak causing peritonitis that demands surgical management by highly skilled surgeons in high-quality surgical units. Material and methods This paper presents one year of experience in the surgical treatment of gastrointestinal perforation-related peritonitis by surgeons in Lahore General Hospital, Lahore, Pakistan. Data was retrospectively collected from patient records and quantitatively analyzed. Involved patients developed peritonitis secondary to gastrointestinal perforation requiring surgical exploration and interventions in the emergency department between November 2020 and October 2021. Results One hundred and fifty-eight patients were involved; the mean age was 43.46 years. The number of males was 87 (55.06%). The patients mostly presented with generalized abdominal pain (57.6%). All the patients had perforation-related peritonitis, which was most prevalent in the ileum (62%). The most performed surgical intervention was loop ileostomy (36.71%). Compared to other published reports, the incidence rate of wound dehiscence in the hospital was relatively higher. Postoperatively, wound infection was low if the skin was left open (23.62%) compared to closed skin (38.7%). Patient outcomes were acceptable as the death rate was low (3.2%, 5/158). Conclusion Peritonitis caused by gastrointestinal perforation is associated with a high risk of morbidity that necessitates surgical exploration. Leaving skin wound open after the surgical intervention is recommended to decrease the incidence of wound infection and dehiscence.

摘要

引言 继发于胃肠道穿孔的腹膜炎在急诊科会导致高发病率和死亡率,急需手术干预。尽管手术管理程序有所改进,但患者仍会因胃肠道渗漏引发腹膜炎,这需要经验丰富的外科医生在高质量的手术科室进行手术治疗。

材料与方法 本文介绍了巴基斯坦拉合尔拉合尔综合医院的外科医生对胃肠道穿孔相关性腹膜炎进行手术治疗的一年经验。数据从患者记录中回顾性收集并进行定量分析。纳入的患者在2020年11月至2021年10月期间因胃肠道穿孔继发腹膜炎,需要在急诊科进行手术探查和干预。

结果 共纳入158例患者;平均年龄为43.46岁。男性87例(55.06%)。患者大多表现为全腹痛(57.6%)。所有患者均患有穿孔相关性腹膜炎,最常见于回肠(62%)。最常进行的手术干预是回肠袢式造口术(36.71%)。与其他已发表的报告相比,该医院伤口裂开的发生率相对较高。术后,皮肤敞开时伤口感染率较低(23.62%),而皮肤缝合时为38.7%。患者的预后尚可,死亡率较低(3.2%,5/158)。

结论 胃肠道穿孔引起的腹膜炎发病率高,需要进行手术探查。建议手术干预后让皮肤伤口敞开,以降低伤口感染和裂开的发生率。