肺炎肠道病的挑战:当代系统性审查
Gennaro Perrone1, Mario Giuffrida2, Valentina Donato2
1Department of Emergency Surgery, Maggiore Hospital, 43126 Parma, Italy.
Journal of personalized medicine
|February 23, 2024
概括
肺炎肠道病的管理是复杂的. "观察和等待"的方法通常是最好的,为不稳定的患者或怀疑肠道缺血,亡或穿孔的患者保留手术.
科学领域:
- 胃肠病学 胃肠病学
- 外科胃肠道外科手术
- 放射学 放射学是一门学科.
背景情况:
- 肠道肺炎是一种放射学发现,原因不明.
- 目前缺乏手术干预的协议.
研究的目的:
- 审查关于肺炎肠道病的紧急手术的文献.
- 为了确定指导手术干预在肺炎肠道的因素.
主要方法:
- 对符合PRISMA标准的文献进行系统审查.
- 在Medline和PubMed搜索了2010年1月至2022年3月的文章.
- 包括报告紧急手术,大肠肺炎和肠道肺炎的研究.
主要成果:
- 分析了1673名患者;平均年龄为67.1岁.
- 在47.9%的病例中,病因不明.
- 血液动力学不稳定 (14.7%) 与肠道缺血,亡或穿孔相关 (p=0.019). 在49.2%的病例中使用了保守的治疗方法,在36.9%的病例中使用了手术. 在不稳定的患者中,有缺血症状,乳酸水平升高或门静脉气体 (PVG) (p=0.0026) 的迹象表明可以进行手术. 155次手术没有发现任何病理发现.
结论:
- 患者管理需要考虑多个变量.
- 识别那些将从手术中受益的患者仍然具有挑战性.
- "观察和等待"的策略是合理的,手术只适用于不稳定的患者或高度怀疑并发症的患者.
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