针对急性膜炎和形成的患者采取量身定制的方法. 该DivAbsc2023多中心病例控制研究
Mauro Podda1, Marco Ceresoli2, Marcello Di Martino3
1Emergency Surgery Unit, Department of Surgical Science, University of Cagliari, Policlinico Universitario "D. Casula", Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Km 4,500, 09042, Monserrato, Italy. mauropodda@ymail.com.
Surgical endoscopy
|April 17, 2024
概括
对分歧的非手术治疗是有效的,但CT扫描Hinchey IIb分类,吸烟和气泡预测失败. 患有分泌炎的吸烟者需要密切监测治疗成功.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 公共卫生 公共卫生
背景情况:
- 椎通常是非手术治疗的.
- 识别治疗失败的风险因素对于患者管理至关重要.
研究的目的:
- 确定CT扫描Hinchey Ib-IIb和WSES Ib-IIa分泌的患者非手术治疗失败的独立风险因素.
主要方法:
- 一项多中心病例控制研究包括了成年患者,他们的第一个CT诊断的分支.
- 患者接受了最初的非手术治疗 (抗生素+/-皮肤通道排水).
- 多变量逻辑回归确定了治疗失败的风险因素 (需要紧急手术).
主要成果:
- 治疗失败发生在27.04%的患者中.
- 失败的独立预测因素包括CT扫描Hinchey IIb分类 (aOR 2.54),烟草吸烟 (aOR 2.01) 和腹气泡 (aOR 1.59).
- 穿皮排水对5厘米以上的治疗成功没有显著的影响.
结论:
- 非手术治疗通常对分泌的治疗有效.
- 烟草吸烟是治疗失败的重要危险因素,需要进行行为干预.
- 患有Hinchey IIb分泌炎的患者,特别是年轻吸烟者,需要对潜在的败血症进展进行警监测.
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