Marie Lindholm, Ivanda Franckeviča, A. Derovs, A. Dabužinskienė, R. Kleina
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引用次数: 0
摘要
摘要胃、肠、胰、胆囊疾病的延迟诊断在并发非外伤性腹膜炎中具有重要意义。该研究的目的是分析致死性腹膜炎的原因,以及导致死亡率和诊断差异的因素。回顾性分析了近三年来1350例尸检记录中52例腹膜炎的病例。我们分析了年龄、性别、住院时间、临床和病理诊断、并发症、合并症、实验室值和诊断差异。采用Excel和IBM SPSS®Statistics version 26对结果进行统计评估。致死性腹膜炎最常见的原因是非肿瘤性胃肠道疾病(26%)、恶性肿瘤(23%)、胰腺和胆囊(16%)、HIV相关(10%)、血管(7%)和其他疾病(18%)。患者平均死亡年龄为65岁。61. 4%为男性。中位住院时间为2天。6名病人在医院外死亡。误诊率为17.4%。常见的误诊情况是肠缺血、各种来源的恶性肿瘤和消化性溃疡穿孔。致死性腹膜炎是由患者因未经治疗的腹腔器官肿瘤和非肿瘤疾病以及多种伴随疾病而延迟住院决定的。其他影响因素包括不去看全科医生,以及患者自身缺乏依从性。
Fatal peritonitis — causes, contributing factors and diagnostic challenges: an autopsy cases study
Abstract Delayed diagnosis of stomach, intestines, pancreas, and gallbladder diseases plays a significant role in the complicated non-traumatic peritonitis. The aim of the study was to analyse the causes of fatal peritonitis, and contributing factors to mortality and diagnostic discrepancies. A retrospective study of 52 peritonitis cases from selected 1350 autopsy records in three years was done. We analysed age, sex, length of hospital stays, clinical and pathological diagnosis, complications, comorbidities, laboratory values and diagnostic discrepancies. The results were statistically assessed by Excel and IBM SPSS® Statistics version 26. The most common causes of fatal peritonitis were non-oncological gastrointestinal pathologies (26%), malignancies (23%), pancreas and gallbladder (16%), HIV related (10%), vascular (7%) and other diseases (18%). Mean age of patients at death was 65 years. 61. 4% were males. Median hospitalisation time was two days. Six patients died outside the hospital. In 17.4% cases misdiagnoses were found. Common situations when misdiagnoses had occurred were intestinal ischaemia, malignancies of various origins and perforation of peptic ulcer. Fatal peritonitis was determined by the patient’s delayed hospitalisation with untreated oncological and non-oncological diseases of organs of the abdominal cavity and multiple concomitant diseases. Other contributing factors included not visiting general practitioners and lack of adherence to patients themselves.