在免疫功能低下患者中复杂的急性斑炎的长期治疗结果
Jorge Sancho-Muriel1, Hanna Cholewa1, Mónica Millán1
1Department of Coloproctology, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
International journal of colorectal disease
|November 4, 2024
概括
急性左侧复杂分泌体炎 (ALCD) 的非手术治疗对于严重免疫功能低下的患者来说是可行的,其成功率与免疫能力较强的个体相似. 这种方法可以避免大多数人出现紧急手术,即使有,这使得它成为一个安全的选择.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 发炎是一种常见的疾病,但严重免疫功能低下的患者的结果不太清楚.
- 急性左侧复杂分泌体炎 (ALCD) 在免疫功能低下的人群中带来了独特的挑战.
研究的目的:
- 为了比较ALCD在严重免疫缺陷 (IMS) 患者与免疫能力 (IC) 患者的非手术治疗的短期和长期结果.
- 在IMS患者的成功非手术治疗后,评估选择性手术的必要性.
主要方法:
- 对第一期ALCD患者 (2012-2018) 的回顾性审查.
- 包括IMS的标准:长期使用类固醇,化疗,透析或移植接受者.
- 对IMS和IC组之间的人口统计数据,严重程度,管理和结果进行比较,包括对ALCD带的亚组分析 (Hinchey Ib/II).
主要成果:
- 在IMS组中,出现的外科手术率更高 (50.0%与22.5%相比),发病率增加 (72.4%与50.0%相比),死亡率增加 (24.1%与4.3%相比),住院时间更长.
- 在IMS患者中显著更高的静脉栓率 (82.1%对22.9%).
- 在IMS和IC组之间,ALCD与的非手术治疗显示出相似的成功率 (81.3%与92.0%) 和复发率 (31.2%与35.4%),大多数IMS患者避免了手术.
结论:
- 在严重免疫功能低下的患者中,非手术治疗ALCD腹是一种可行且成功的策略.
- 没有延迟选择性手术的保守管理对于IMS患者来说似乎是安全的,考虑到复发,再入院和术后风险.
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