腹形成的肠炎:非手术治疗的结果和预测紧急手术的诺莫图:Diplicab研究合作小组
Juan Ocaña1, Juan Carlos García-Pérez1, Daniel Fernández-Martínez2
1Division of Coloproctology, Department of General and Digestive Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Surgery
|June 29, 2023
概括
对于带膜炎,考虑通过皮肤排水较大的 (≥5厘米),以减少紧急手术. 一个新的名图可以帮助外科医生预测紧急干预的必要性.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 医疗信息学 医疗信息学
背景情况:
- 腹形成的膜炎需要谨慎管理,以优化患者的治疗结果.
- 非手术方法很常见,但预测急诊手术的需要仍然是一个挑战.
研究的目的:
- 评估非手术治疗腹性分泌体炎的短期和长期结果.
- 在这些患者中开发一个用于紧急手术干预的预测性名录.
主要方法:
- 在29个西班牙中心 (2015-2019) 进行了一项全国性的回顾性队列研究,对1395名患有第一个发作分歧 (修改后的Hinchey Ib-II) 的患者进行了全国性研究.
- 分析紧急手术的发生率,并发症和复发情况.
- 使用回归分析开发名图,以确定紧急手术的风险因素.
主要成果:
- 84.9%的患者仅用抗生素治疗; 13.9%需要紧急手术.
- 腹≥5厘米的皮肤间排水与较低的紧急手术率 (19.9%与29.3%) 有关.
- 紧急手术的关键预测因素包括免疫抑制,高C反应蛋白,自由肺,Hinchey II分类,较大的腹大小和吗啡使用. 诺米图实现了0.81.1的AUC.
结论:
- 应考虑通过皮肤排水进行形 ≥5厘米,以减少紧急手术的发生率.
- 开发的诺米图为外科医生提供了一个工具,可以个性化治疗策略,并预测需要紧急手术的可能性.
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