摘要
目的 评价自行设计腹膜炎评分方法的合理性和安全性。方法 对 4 0 5例继发性腹膜炎 (SP)急诊手术同时应用自行设计的腹膜炎评分和APACHEⅡ评分 ,比较二者之间的相关性。根据腹膜炎评分 ,≤ 6分病例 (A组 )仅予术前单剂预防性抗生素 ,术后不用抗生素 ;≥ 7分病例 (B、C组 )除术前预防性应用抗生素以外 ,术后还治疗性应用抗生素 ;比较两组病例的术后并发症发生率和病死率 ,显著性差异比较用 χ2 检验。结果 4 0 5例SP病例的腹膜炎评分和APACHEⅡ评分呈明显线性正相关 (r =0 89,P <0 0 1)。SP术后特异性并发症发生率和病死率均随腹膜炎评分增加而上升 ,A组术后腹腔残余感染率和病死率均为 0。结论 自行设计的腹膜炎评分能准确判断SP病例的严重程度。根据此评分方法进行规范化抗生素治疗 ,免除了轻症SP术后的不必要用药 ,但不增加其并发症发生率和病死率 ,具有合理、简便、安全、可靠等优点。
Objective\ To evaluate the rationality and security of self-designed peritonitis scoring method.Methods\ The peritonitis scoring and APACHEⅡ scoring were used concurrently in 405 patients with secondary peritonitis who underwent emergent laparotomy,and the results and clinical outcomes were compared between them.According to the peritonitis scoring,the cases in which the scoring ≤6 were given a single-dose prophylactic antibiotic before emergent laparotomy and none postoperatively,the cases in which the scoring ≥7 were given prophylactic antibiotic preoperatively and therapeutic antibiotic postoperatively.The incidence of the complications and the mortality were compared between them,and the statistical difference was evaluated by χ 2 test.Results\ In the 405 cases,there was significant positive linear relativity between the peritonitis scoring and APACHEⅡ scoring.The incidence of the special complications and the mortality after laparotomy were increased with the elevation of the peritonitis scoring.In the cases with the scoring ≤6,the incidence of the intra-abdominal remainder infection and the mortality after laparotomy were all 0 Conclusion\ The self-designed peritonitis scoring can predict exactly the severity of the cases with secondary peritonitis.According to this scoring method,we can carry through the canonical antibiotic therapy,avoid the useless therapeutic antibiotic after operation of the cases with secondary peritonitis in which the peritonitis scoring ≤6 (which was 40 32% of the 405 cases).It doesn't increase the incidence of the special complications and the mortality after emergent laparotomy of the cases with secondary peritonitis,and it is a rational,covenient,secure and reliable peritonitis scoring method.
出处
《中国实用外科杂志》
CSCD
北大核心
2002年第6期349-352,共4页
Chinese Journal of Practical Surgery
