Marchildon M B, Dudgeon D L
Ann Surg. 1977 Jan;185(1):84-7. doi: 10.1097/00000658-197701000-00014.
A review of 89 consecutive cases of perforated appendicitis recently treated surgically at Childrens Hospital of Los Angeles revealed no mortality and a complication rate of 17%. Significant factors in this low morbidity are: adequate preoperative resuscitation, routine administration of broad spectrum antibiotics pre and postoperatively, and attention to surgical detail. Anaerobic organisms were invariably present in cultures of the peritoneal fluid taken at operation. Anaerobes were also present in the blood in all 5 patients having positive blood cultures and were frequently pathogens whenever postoperative infectious complications occurred. The use of antibiotics effective against anaerobic organisms was common in this series and produced no morbidity.
对洛杉矶儿童医院近期接受手术治疗的89例连续性穿孔性阑尾炎病例进行回顾发现,无死亡病例,并发症发生率为17%。发病率较低的重要因素包括:术前充分复苏、术前后常规使用广谱抗生素以及注重手术细节。手术时采集的腹腔积液培养物中始终存在厌氧菌。所有5例血培养呈阳性的患者血液中也存在厌氧菌,术后发生感染性并发症时,厌氧菌常为病原体。在该系列病例中,使用对厌氧菌有效的抗生素很常见,且未产生不良影响。