Fry D E, Garrison R N, Heitsch R C, Calhoun K, Polk H C
Surgery. 1980 Oct;88(4):517-23.
To better define determinants of death in patients with intraabdominal abscess, 143 patients from a 5-year hospital experience were reviewed. Abscesses were most commonly results of trauma, spontaneous gastrointestinal perforations, and technical errors. Clinical presentation of abscess was quite variable as were criteria to justify reoperation for drainage. Abscesses occurred most commonly in the subphrenic space, pelvis, or subhepatic space. Complete abdominal exploration was employed most frequently for drainage. Those factors that were associated with a fatal outcome were: organ failure (P < 0.001), lesser sac abscess (P < 0.001), positive blood culture (P < 0.01), recurrent and/or persistent abscess (P < 0.01), multiple abscesses (P pE 0.01), age > 50 years (P < 0.03), and subhepatic abscess (P < 0.03). These data suggest that deaths from abdominal abscess are consequences of ineffective surgical drainage and failure of host defense mechanisms.
为了更好地明确腹腔脓肿患者的死亡决定因素,我们回顾了一家医院5年间收治的143例患者的情况。脓肿最常见的病因是创伤、自发性胃肠道穿孔和技术失误。脓肿的临床表现差异很大,再次手术引流的标准也是如此。脓肿最常发生于膈下间隙、盆腔或肝下间隙。最常采用的是全腹探查引流术。与致命结局相关的因素有:器官衰竭(P<0.001)、小网膜囊脓肿(P<0.001)、血培养阳性(P<0.01)、复发性和/或持续性脓肿(P<0.01)、多发性脓肿(P<0.01)、年龄>50岁(P<0.03)以及肝下脓肿(P<0.03)。这些数据表明,腹腔脓肿导致的死亡是手术引流无效和宿主防御机制失败的结果。