感染性结核性胰腺炎 (POINTER) 患者的立即与推迟干预的长期结果:多中心随机试验
Charlotte L Van Veldhuisen1,2,3, Noor J Sissingh3,4, Lotte Boxhoorn2,5
1Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Annals of surgery
|July 14, 2023
概括
对于感染性瘤性胰腺炎,使用抗生素推迟排水方法导致长期干预较少,而不是立即排水. 这种策略被推用于更好的患者管理和更少的手术.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 传染性疾病 传染性疾病
背景情况:
- 感染性瘤性胰腺炎带来了复杂的管理挑战.
- 以前的POINTER试验表明,推迟排水的干预措施较少.
研究的目的:
- 为了比较长期的结果,即时与推迟排水在感染瘤性胰腺炎.
- 评估干预的必要性和初始治疗后患者的整体状况.
主要方法:
- 重新评估6个月后活着的患者的临床数据.
- 主要结局:死亡和重大并发症的复合.
- 平均随访时间为51个月.
主要成果:
- 两组之间主要结局 (死亡/严重并发症) 没有显著差异 (15%对17%).
- 推迟排水组需要更少的额外排水程序 (7%对15%).
- 在整个随访期间,推迟排水组的总干预显著减少 (中位数为1比4).
结论:
- 用抗生素推迟排水的方法在长期内与更少的干预有关.
- 这种方法应首选用于管理感染性死性胰腺炎.
- 长期的胰腺功能和生活质量在各组之间是相似的.
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