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由于性结肠炎导致的有毒大结肠患者的手术管理
Toshifumi Watanabe1, Daijiro Higashi1, Hiroki Kaida1
1Department of Surgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Journal of the anus, rectum and colon
|August 1, 2024
概括
有毒的大结肠 (TM) 需要使用Narabayashi和SIRS等标准进行早期识别. 迅速的外科干预对于管理TM至关重要,即使有不完整的临床发现,以改善患者的治疗结果.
科学领域:
- 胃肠病学 胃肠病学
- 外科胃肠道外科手术
- 关键护理医学 关键护理医学
背景情况:
- 毒性大结肠 (TM) 由于严重程度变化和缺乏标准化标准,因此存在诊断挑战.
- 早期识别和管理对于改善TM病例患者的治疗结果至关重要.
研究的目的:
- 审查有毒巨结肠 (TM) 病例的外科治疗方法.
- 总结TM的手术时间和手术技术.
- 确定成功手术治疗TM的关键因素.
主要方法:
- 对接受手术的TM患者进行单中心回顾性研究 (1985-2020年).
- 诊断和败血症查标准 (SIRS,qSOFA,MEWS) 的验证.
- 术前临床特征和术后发现的分析.
主要成果:
- 九名患者 (64.3%) 符合Narabayashi标准,10名 (71.4%) 符合SIRS标准.
- 两名患者 (14.3%) 经历了肠道穿孔,这些病例的死亡率为50%.
- 11名患者 (78.6%) 接受了全身切除术和末端结肠切除术.
结论:
- 由于定义不清的标准和各种表述,诊断TM需要考虑各种发现.
- 纳拉巴亚希和SIRS标准是推的TM毒性指标.
- 对TM的早期手术考虑至关重要,即使不符合所有临床标准.
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