术前评分系统用于预测急性尾炎紧急手术期间的延长切除
Toshimichi Kobayashi1, Eiji Hidaka1, Akitoshi Ando1
1Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 193-0998, Japan.
Langenbeck's archives of surgery
|November 21, 2023
概括
一个新的评分系统有助于预测急性尾炎病例中需要扩展切除 (ER) 的需要. 这种工具有助于外科医生识别需要ER的复杂尾炎,改善治疗决策.
科学领域:
- 外科手术的结果
- 医学中的预测建模.
- 胃肠道手术 胃肠道手术
背景情况:
- 尾切除术是急性尾炎的标准.
- 扩展切除 (ER) 有时对于复杂的病例是必要的.
- 在手术前预测ER是具有挑战性的.
研究的目的:
- 开发一个术前评分系统,用于预测急性尾炎的ER.
- 帮助在手术前识别具有挑战性的尾炎病例.
主要方法:
- 对179名接受紧急尾炎手术的患者进行了回顾性单中心研究.
- 多变量逻辑回归确定了ER的独立预测因素.
- 一个评分系统被开发和验证使用AUC.
主要成果:
- 12名患者 (6.7%) 需要ER.
- 预测ER的预测因素包括手术≥4天后的症状发作,尾/尾尾,以及的存在.
- 评分系统 (0-6) 显示出强烈的歧视 (AUC=0.877) ,ER率为2.5% (低风险),28.6% (中等风险) 和80% (高风险).
结论:
- 开发的评分系统有效地预测了急性尾炎中对ER的需求.
- 这种工具可以帮助外科医生在复杂的尾炎病例中做出手术前决策.
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