当科における大腸穿孔83例の臨床的検討

Introduction : Colon perforation easily causes septic shock and multiple organ failure, mortality rate is high. We studied prognostic factors with colon perforation. From January１９９９to December ２００８, ８３ patients with colon perforation underwent emergency surgery in this department.
Methods : Subjects were retrospectively divided into survivors（n＝６７）and nonsurvivors（n＝１６）. We studied their clinical factors and compared mortality for each factors. Results : Overall mortality was１９％ １６／８３）. The mean age was７４years, and significantly higher mortality over ８０years. The cause perforation was idiopathic in２５cases, cancer in２１cases, diverticulitis in１９ cases, iatrogenic in８cases, trauma in２cases, others in８cases. The perforation site was the most sigmoid colon. Patients with SOFA score at least five points before surgery and preoperative shock and leucopenia and older than２４hours before surgery was significantly higher mortality. Each was no difference in complications before surgery. PMX-DHP was performed in ３９ cases １３％ mortality. Discussion : In patients with colon perforation, preoperative assessment SOFA score was trusted to reflect the outcome.

四国医学雑誌 : http://www.tokushima-u.ac.jp/med/research/shikoku_acta_medica.html