在患有结直肠椎穿孔的患者中,术后死亡的危险因素
Yutaro Nakagawa1, Shuhei Ito1, Kozue Nakahara1
1Department of Surgery, Fukuoka Tokushukai Hospital, Kasuga, Japan.
Journal of the anus, rectum and colon
|October 30, 2024
概括
对于穿孔结直肠分泌器患者来说,抗血栓药物和高乳酸水平是关键的危险因素. 在严重的病例中,聚氨酸B固定纤维柱直接血 perfusion (PMX-DHP) 没有显示任何益处.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 关键护理医学 关键护理医学
背景情况:
- 需要手术的结肠直肠分管穿孔的预后不好.
- 在这些患者中,polymyxin B-不动化的纤维柱直接输血 (PMX-DHP) 的有效性仍未确立.
研究的目的:
- 为了确定手术治疗患有穿孔结直肠分泌器的患者的预后因素.
- 评估PMX-DHP在该患者队列中的疗效,特别是在严重病例中.
主要方法:
- 对46名患有穿孔结肠直肠分泌器的患者进行了回顾性审查,这些患者接受了紧急手术.
- 在生存率和死亡率组之间比较手术前,手术后和术后的因素.
- 在严重病例中对PMX-DHP疗效的子组分析.
主要成果:
- 手术后死亡率为15.2% (7/46名患者).
- 在死亡率组中使用PMX-DHP的频率更高 (30.4%).
- 抗血栓药物使用和乳酸盐水平 (≥3.0 mmol/L) 是死亡的独立风险因素. 在严重病例中,PMX-DHP并没有改善预后.
结论:
- 抗血栓药物管理和乳酸水平升高是结肠直肠穿孔的显著独立预后因素.
- 在患有严重手术前疾病,包括高乳酸盐水平的患者中,PMX-DHP可能不有效.
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