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在急性中肠缺血症的术内开放和内血管再血管化后的结果,需要进行腹腔切除术
Marvin Kapalla1, Rahul Choubey2, Jürgen Weitz2
1Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Dresden, TU, Germany. Marvin.Kapalla@uniklinikum-dresden.de.
Langenbeck's archives of surgery
|August 10, 2023
概括
治疗急性介质缺血 (AMI) 的结果与开放式手术和内血管方法相似. 晚期疾病和并发症增加了AMI患者的死亡风险.
科学领域:
- 血管外科 血管外科
- 胃肠病学 胃肠病学
- 干预性放射学 干预性放射学
背景情况:
- 急性中肠缺血 (AMI) 呈现出诊断上的挑战和高死亡率.
- 选择偏差使得AMI的内血管和开放外科治疗之间的比较变得复杂.
- 评估AMI治疗结果需要仔细考虑患者的基线状态.
研究的目的:
- 为了比较需要腹腔切除术的患者对AMI的开放性手术与内血管治疗的结果.
- 在AMI的特定临床场景中评估内血管第一策略的有效性.
- 确定与AMI患者死亡相关的风险因素.
主要方法:
- 74名AMI患者的临床数据的回顾性审查 (2007-2021年).
- 开放式手术 (OT) 和内血管 (ET) 方法之间的住院死亡率的比较.
- 单变量和多变量分析以确定死亡风险因素.
主要成果:
- 住院死亡率总体为43% (41%的OT与53.8%的ET相比;P=0.54).
- 死亡的独立风险因素包括肠道肺炎,乳酸水平升高和缺血性肠道部位.
- 患者年龄,严重的心脏衰竭和心房动与单变量分析的死亡率增加有关.
结论:
- 对AMI的发病率和死亡率仍然很高.
- 开放式和内血管治疗在经过腹腔切除术的患者中产生了类似的结果.
- 晚期疾病阶段和心血管并发症预测AMI的不良结果.
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