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在儿童的指数粘合性小肠阻塞的管理趋势
Utsav M Patwardhan1, Gretchen M Floan1, Richard Y Calvo2
1Department of General Surgery, Naval Medical Center San Diego, San Diego, California.
The Journal of surgical research
|September 3, 2023
概括
大多数患有粘性小肠阻塞 (ASBO) 的儿童接受手术管理 (OPM). 晚期手术会增加住院时间和并发症,但不会影响肠切除或死亡率.
科学领域:
- 儿科手术 儿科手术
- 胃肠道手术 胃肠道手术
- 医疗保健服务研究 医疗服务研究
背景情况:
- 粘性小肠阻塞 (ASBO) 是儿童常见的一种手术疾病.
- 儿科ASBO的管理策略范围从非手术护理到手术干预.
- 了解实践模式和结果对于优化儿科ASBO护理至关重要.
研究的目的:
- 分析指标粘性小肠阻塞 (ASBO) 的儿童非手术与手术管理 (OPM) 的实践模式.
- 为了比较儿科ASBO的不同管理策略之间的手术结果.
- 确定影响非操作和操作方法之间选择的因素.
主要方法:
- 利用加利福尼亚州全州医疗出院数据库 (2007-2020年) 识别 ASBO 指数的儿科患者 (<18岁).
- 评估的初始管理模式:非手术 vs. OPM,以及早期 (≤3天) vs. 晚期 (>3天) 手术.
- 评估了二次结果,包括医院特征,患者人口统计和术后并发症.
主要成果:
- 在2297个确诊的儿科ASBO病例中,有85%的病例采用了操作管理 (OPM).
- 与早期手术相比,晚期手术 (>3天) 与更长的停留时间,增加的传染性并发症和更高的总体亲肠道营养使用有关.
- 在早期和晚期手术管理之间,没有观察到肠切除率或死亡率的显著差异.
结论:
- 在儿童,特别是新生儿和幼儿中,观察到高水平的操作管理 (OPM) 指数ASBO.
- 虽然晚期手术增加了逗留时间和传染性并发症,但它没有影响肠切除或死亡率.
- 需要进一步的研究来完善管理策略,并优化儿科ASBO的结果.
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