Bohnen J, Boulanger M, Meakins J L, McLean A P
Arch Surg. 1983 Mar;118(3):285-90. doi: 10.1001/archsurg.1983.01390030017003.
Generalized peritonitis was assessed in 176 patients, 67 (38%) of whom died. Cases were divided into causative groups: (1) appendicitis and perforated duodenal ulcer, (2) intraperitoneal origin other than appendix or duodenum, and (3) postoperative peritonitis. Mortalities were 10%, 50%, and 60%, respectively. Postoperative peritonitis was characterized by lack of influence of age on outcome, late operation, and more frequent organ failure. Delayed surgery carried a worse prognosis. Organ failure was a risk factor with 76% mortality, and was associated with late operation. Early surgery in organ failure improved survival. More sensitive indicators of early organ dysfunction might improve survival.
对176例患者进行了弥漫性腹膜炎评估,其中67例(38%)死亡。病例分为病因组:(1)阑尾炎和十二指肠溃疡穿孔,(2)阑尾或十二指肠以外的腹腔内源性病因,(3)术后腹膜炎。死亡率分别为10%、50%和60%。术后腹膜炎的特点是年龄对预后无影响、手术延迟以及器官衰竭更常见。手术延迟预后更差。器官衰竭是一个危险因素,死亡率为76%,且与手术延迟有关。器官衰竭时早期手术可提高生存率。更敏感的早期器官功能障碍指标可能会提高生存率。