Nguyen V S
Service de Chirurgie Générale, Hôpital Angiang, Viet Nam.
J Chir (Paris). 1994 Feb;131(2):90-5.
Peritonitis due to typhus is still frequent in Vietnam. We studied retrospectively 83 cases of 83 patients operated for peritoneal perforations due to typhus between January 1986 and December 1987. There were more males than females (56 versus 27) and most of the patients were under 30 years of age (72.2%). The diagnosis was made on the basis of clinical picture of fever associated with peritonitis and ileal lesions seen at laparotomy. Treatment for most patients included surgical exeresis, suture of the perforation and lavage and draining of the abdominal cavity. Fifteen patients died during the perioperative period (18% operative mortality). There were 76 cases of post-operative complications involving 55 patients. The most frequent complication was parietal infection observed in 55 cases (66.3%). The most severe complication was suture failure seen in 5 cases, 4 of which had a fatal outcome. Operative delay was a statistically significant factor of prognosis. In the specific situation of our clinical experience, simple suture or suture excision remain the most adapted and effective modes of treatment.
在越南，斑疹伤寒所致腹膜炎仍很常见。我们回顾性研究了1986年1月至1987年12月间因斑疹伤寒导致腹膜穿孔而接受手术的83例患者的83个病例。男性多于女性（56例对27例），且大多数患者年龄在30岁以下（72.2%）。诊断依据为发热伴腹膜炎的临床表现以及剖腹手术时所见的回肠病变。大多数患者的治疗包括手术切除、穿孔缝合、腹腔灌洗和引流。15例患者在围手术期死亡（手术死亡率为18%）。有76例术后并发症，涉及55例患者。最常见的并发症是55例（66.3%）出现的腹壁感染。最严重的并发症是5例出现的缝合失败，其中4例导致死亡。手术延迟是一个具有统计学意义的预后因素。根据我们的临床经验，在特定情况下，单纯缝合或缝合切除仍是最适用且有效的治疗方式。
