在非手术治疗中复发性胆囊炎的临床预测因素:系统性审查和元分析
Ahmed Salama1, Gavin G Calpin1, Raymond Fuller1
1Department of Surgery, Beaumont Hospital, Beaumont, Dublin.9, D09V2N0, United States; Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin.2, D02YN77, United States.
概括
在保守的管理后预测胆结石复发至关重要. 年龄,胆道疾病史和胆囊炎的严重程度是潜在的指标,但需要更多的研究来获得可靠的风险工具.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 胆道疾病 胆道疾病
背景情况:
- 胆结石病很常见,影响患者的健康和医疗保健成本.
- 腹腔镜胆囊切除术通常是首选的,但并不总是可行的,导致保守的管理.
- 急性胆囊炎的保守管理需要了解复发风险.
研究的目的:
- 系统地审查关于急性胆囊炎非手术治疗患者复发的临床预测因素的文献.
- 在保守治疗的患者中确定与复发性急性胆囊炎 (ACR) 相关的因素.
主要方法:
- 系统的文献审查遵循PRISMA和MOOSE的指导方针.
- 包括对患有急性胆囊炎复发患者的变量进行比较的研究.
- 从相关研究中分析临床,生化和放射学数据.
主要成果:
- 三项涉及678名患者的研究显示,复发率为28.5%.
- 潜在的ACR预测因素包括年龄,先前的胆道疾病和胆囊炎的严重程度.
- 生物化学标志物 (炎症标志物,白血球,白蛋白) 和放射学发现 (胆囊壁厚度,结石特征) 也可以预测复发.
结论:
- 识别患有复发性胆囊炎风险的患者有助于临床决策.
- 目前关于预测因素的证据有限且不确.
- 需要进行更大规模的研究,以开发有效的风险分层工具来管理胆结石疾病.
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