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慢性肠道伪阻塞和需要息治疗的自然史
Kosuke Tanaka1,2, Hidenori Ohkubo2,3, Atsushi Yamamoto2
1Department of Palliative Medicine and Gastroenterology, International University Health and Welfare Narita Hospital, Narita, Japan.
Journal of neurogastroenterology and motility
|July 7, 2023
概括
慢性肠道伪阻塞 (CIPO) 是一种严重的,罕见的疾病,成人自然史不明. 这项研究强调了显著的息护理需求,并表明标准化治疗策略对于管理CIPO患者至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 罕见疾病 罕见疾病
背景情况:
- 慢性肠道伪阻塞 (CIPO) 是一种罕见的胃肠道运动障碍.
- 成年人中CIPO的自然史和临床过程仍然不太清楚.
- 这项研究旨在阐明成人CIPO患者的临床进展和息护理需求.
研究的目的:
- 评估被诊断患有CIPO的成年患者的临床过程和结果.
- 评估疾病进展期间所需的营养状况和治疗干预措施.
- 确定患有CIPO的个人的息护理需求.
主要方法:
- 从2010年到2021年,前性研究包括74名通过电影MRI诊断的CIPO成年患者.
- 收集的数据包括疾病病因,发病/诊断年龄,营养标志物 (BMI,白蛋白),气呼吸测试以及TPN和减压等治疗方法.
- 分析了疾病结果,死亡原因和患者报告的息护理偏好.
主要成果:
- 研究队列 (n=74) 在诊断时平均年龄为49岁,其中64%为女性. 初级CIPO发生在65%的病例中,二级CIPO发生在35%的病例中 (18%与硬质皮相关).
- 营养不良 (平均BMI为17 kg/m2,白蛋白低) 是常见的. 31%的患者需要全方位肠道营养 (TPN),24%的患者需要减压治疗. 肠道绝育在65%的患者中是有效的.
- 死亡率为12% (9人死亡),感染和自杀是原因. 显著多数 (69%) 表示希望接受息治疗.
结论:
- CIPO是一种严重且未被认可的疾病,患病率和死亡率很高.
- 标准化治疗方案至关重要,包括营养支持,治疗干预以及综合性息和精神病治疗.
- 需要进一步的研究来改善CIPO的管理策略和患者的治疗结果.
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