在紧急胃肠外科手术后预测粘性小肠阻塞的诺莫грам
Puyue Gao1, Zongping Yu2, Yiqi Wang3
1Department of Gastroenterology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, 266035, Shandong, China.
Langenbeck's archives of surgery
|October 5, 2023
概括
一种新型的诺米图准确预测了紧急胃肠外科手术 (EGS) 后粘性小肠阻塞 (ASBO) 的风险. 这种工具有助于外科医生定制预防措施,以改善患者的治疗结果.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床风险预测预测
背景情况:
- 在腹部手术后,术后粘附是常见的,导致严重的并发症.
- 在紧急胃肠道手术 (EGS) 后预测粘性小肠阻塞 (ASBO) 风险目前具有挑战性.
- 需要一个可靠的外科外科模型来进行个性化的ASBO监测.
研究的目的:
- 在接受EGS的患者中开发和验证ASBO风险的预测模型 (nomogram).
- 为指导经营期间的管理和监测策略提供一个工具.
主要方法:
- 一组1296名因炎症或穿孔而接受EGS的患者被用于构建名图.
- 外部验证使用独立的患者队列进行.
- 多变量物流分析确定了ASBO的独立风险因素.
主要成果:
- 在平均26个月的随访期间,ASBO在8.9%的患者中发生.
- 确定了独立的风险因素:男性性别,手术前低白蛋白,先前的盆腔放射治疗,腹腔切除术和长时间的重症监护室停留 (≥72h).
- 在外部验证中,名图显示出良好的预测准确性 (C指数为0.852).
结论:
- 一个经过验证的nomogram可以准确地评估个人ASBO风险后EGS.
- 将这个名图集成到外科手术期间的护理中可以指导预防策略.
- 改进的风险评估可能会导致更好的患者结果和减少ASBO发病率.
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