胆石とアルコールの乱用による重度の急性炎の患者における臓および周辺臓死滅の介入的および非介入的治療に関する8年間の経験. 単一センター分析
Davide Di Mauro1, Alex Reece-Smith1, Ikechukwu Njere1
1Department of Upper GI Surgery, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK.
Acta chirurgica Belgica
|August 30, 2025
まとめ
重度の急性炎 (AP) は,しばしば介入が必要である. 大量の蓄積,感染性ネクロス,ICU入院は侵襲的な治療の必要性を予測し,皮膚経由の排水が有効であることが示されています.
科学分野:
- 胃腸内科
- 外科 胃腸科
- 放射線科
背景:
- 急性臓炎 (AP) と臓および臓周末死 (PNとPPN) の治療は困難です.
- PN と PPN の AP の保守的な対侵襲的な治療に対する反応の予測は不明である.
研究 の 目的:
- PNとPPNによる胆石またはアルコールの誘発によるAPの患者の臨床および放射線学的特徴を評価する.
- 介入治療と非介入治療の結果を比較する
主な方法:
- 胆石またはアルコール誘発性APの患者とPNとPNの放射線学的証拠 (2010年−2018年) の遡及研究.
- 介入 (皮膚抜きと/または手術による死体切除) と非介入のグループに分かれました.
- グループ間の臨床的および放射線学的特徴の比較
主要な成果:
- 18人の患者は介入治療を受け,81人は保守的な治療を受けた.
- 介入グループは,より大きなPNと感染性ネクロスの割合を示した.
- 介入の予測要因には,大きな急性死骸の集合 (> 10 cm),感染した死骸,ICU入院が含まれています.
結論:
- ほとんどの重度の胆石およびアルコール関連のAPは医学的に管理されました.
- 大量の急性死骸の収集,感染した死滅,ICU入院は介入の必要性を予測しました.
- 侵襲的な治療が必要で,しばしばドレイン挿入を繰り返す場合,皮膚経由の排水のみが有効でした.
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