STUDIES ON 174 CASES OF INTESTINAL OBSTRUCTION WITH REFERENCE TO THE DIAGNOSIS AND APACHE II SCORE

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  • イレウス174例の検討-診断とAPACHE II scoreを中心に-

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Abstract

In recent years therapeutic outcomes of interstinal obstruction improved with a progression in preand intra-operative management, however, there are still some unfortunate patients with a fatal course derived from difficulty in selecting appropriate operative candidate. We need to study harder. The purpose of this study is to examine these ileus cases retrospectively based on “APACHE II score” that will contribute to accurate and prompt treatment. Subjects were 174 cases of intestinal obstruction except those of secondary. As a result, all patients with peritoneal sign on admission were indicated an operation who had circulatory disturbance of the intestine. In most necropsy cases the APACHE scores were 11 or higher. pH levels of arterial blood were significantly lower, and serum creatinine levels were significantly higher. It is concluded that physical findings of the abdomen are important for making the diagnosis and the definitive diagnosis should be made comprehensively based on other laboratory data including APACHE II score. APACHE II score is relaiable anduseful as the criterion of the severerity of the disease, but arterial blood pH and serum creatinine level are also useful as simple criteria of the severity.

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