紧急的副食道:我们能做得更好吗?
Yehuda Hershkovitz1, Amir Ben Yehuda2, Daniel Dykman1
1Trauma Unit, Shamir Medical Center Affiliated with University Tel Aviv, Zerefin, Israel.
Journal of laparoendoscopic & advanced surgical techniques. Part A
|November 27, 2023
概括
副食道 (PEH) 往往表现为模糊的症状,导致在急诊室错过诊断. 迅速的手术修复,特别是在急性病例中,对于更好的患者结果至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 手术病理学手术病理学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 副食道 (PEH) 是一种常见的疾病,其症状模仿其他病理.
- 手术干预是急性PEH的标准,但选择性手术的指示仍在争论中.
- 急诊室 (ER) 医生可能会忽视PEH症状,导致诊断和治疗延迟.
研究的目的:
- 评估患有副食道 (PEH) 的患者的管理.
- 分析急性PEH病例的结果,特别是以前从ER出院的病例.
- 突出在紧急情况下诊断PEH的重要性.
主要方法:
- 对接受腹腔镜PEH修复的98名患者的回顾性分析 (2017年1月 - 2023年5月).
- 患者分为急性 (ER入院) 和选择性手术组.
- 根据先前的急诊室访问和错过的PEH诊断,对急性病例的子组分析.
主要成果:
- 28名患者 (28.9%) 属于急性PEH组 (I组).
- 两组之间观察到年龄,症状和并发症的显著差异.
- 14名急性患者先前曾在急诊室就诊;12名患者的成像显示PEH,表明错误诊断.
结论:
- 选择性腹腔镜PEH修复与更好的患者结果有关.
- 紧急医生可能会低估PEH,需要更高的怀疑指数.
- 准确及时诊断PEH对于有效的ER管理至关重要.
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