自发食道破裂治疗方式的结果:元分析和病例系列
Jiajian Pan1,2, Yong Ge1,2, Tianci Feng1,2
1Thoracic Surgery Laboratory, Xuzhou Medical University.
International journal of surgery (London, England)
|July 25, 2024
概括
食道破裂治疗结果因方法而异;食道切除术提供了最好的结果,而初级关闭和支架是可行的替代方案. 在24小时内进行早期干预显著提高了自发食道穿孔的生存率.
科学领域:
- 医学研究 医学研究
- 手术方面的创新.
- 胃肠病学 胃肠病学
背景情况:
- 自发食道穿孔 (Boerhaave综合征) 的治疗由于其罕见而仍有争议.
- 关于各种管理策略的比较结果的数据有限.
研究的目的:
- 分析机构对自发食道破裂管理的经验.
- 进行现有文献的元分析,以确定最佳的基于证据的治疗方法.
主要方法:
- 在该机构治疗的17名患者的病例系列.
- 在MEDLINE,EMBASE和Cochrane图书馆数据库中进行系统的文献搜索 (截至2024年4月1日).
- 46项研究的元分析,包括944名患者.
主要成果:
- 消化管切除术显示了最低的即时死亡率 (2%).
- 主要关闭 (6%) 和食道支架 (8%) 显示了相似的结果.
- 延迟治疗 (>24小时) 显著增加死亡率 (12%vs3%如果在24小时内接受治疗).
结论:
- 食道切除术为自发食道破裂提供了最好的结果.
- 主要关闭和食道支架是有效的替代方案.
- 及时诊断和24小时内干预对于降低死亡率至关重要.
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