结直肠穿孔手术后术后并发症和医院死亡率的危险因素
Kensuke Kudou1, Shuhei Kajiwara1, Takashi Motomura1
1Department of Surgery, Iizuka Hospital, Iizuka, Japan.
Journal of the anus, rectum and colon
|May 1, 2024
概括
结直肠穿孔的延迟手术和基于炎症的低预后得分 (IBPSs),如PNI,NLR和PLR,与更糟糕的结果有关. 这些因素预测了紧急结直肠手术后的并发症和死亡率.
科学领域:
- 外科胃肠道外科手术
- 关键护理医学 关键护理医学
- 炎症生物标志物 炎症生物标志物
背景情况:
- 结肠直肠穿孔在紧急外科干预后存在严重的发病和死亡风险.
- 确定术后并发症和死亡率的预测因素对于改善患者的治疗结果至关重要.
研究的目的:
- 为了研究患有结直肠穿孔急诊手术的患者的临床特征.
- 在这个患者队列中,确定与术后并发症和医院死亡率相关的风险因素.
主要方法:
- 回顾147名因结直肠穿孔而接受紧急手术的患者的数据.
- 对临床和手术因素的分析,包括基于炎症的预后得分 (IBPSs).
- 对特定并发症 (伤口感染,腹内) 和医院死亡率的风险因素的评估.
主要成果:
- 最常见的并发症是伤口感染 (21.8%) 和腹内 (18.4%).
- 手术延迟 (≥2天),预后营养指数低 (PNI <30) 和中性粒细胞-淋巴细胞比率低 (NLR <6.15) 与特定的并发症有关.
- 手术延迟,严重的术后并发症 (Clavien-Dindo ≥ IIIa) 和低血小板-淋巴细胞比率 (PLR < 144) 独立预测了医院死亡率.
结论:
- 手术前的时间和IBPS (PNI,NLR,PLR) 与结直肠穿孔术的术后并发症和医院死亡率显著相关.
- 这些炎症标志物和手术时间为风险分层和早期干预提供了潜力.
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