敗血症,ショック : 胃破裂症例を中心に(II 重症症例の治療の進歩, 25周年記念シンポジウム論文)

概要

論文の詳細を見る
In a 10-year period from 1978 to 1987, 42 newborn infants with acute peritonitis due to gastrointestinal perforation consisting of 31 with gastric rupture and 11 with intestinal perforation were operated upon at the Niigata University Hospital. Seventeen infants in this series suffered from sepsis with or without septic shock and 13 of them died. Of 31 infants with gastric ruture, 12 were involved by sepsis or septic shock and 8 died. Low birth-weight and acidosis were more remarkable in infants who died than in those who survived. Of 10 infants who received the limilus test, 6 were positive for endoxin in the blood and 5 died. Certain kinds of bacilli were identified in ascites of 8 infants, and 7 of them died. Bacteremia was seen in 6 of 9 infants who received blood culture test, and 5 of them died. Conclusion : 1 ) It was not easy to establish a diagnosis of sepsis on the infants with acute peritonitis due to gastrointestinal perforation. 2 ) Early treatments with protease inhibitor, γ-globulin, protanol, hydrocortison, antibiotics, increased the survival rate of the infants with sepsis. 3 ) Blood exchange seemed to be a best useful treatment for sepsis with DIC.
1989-10-20