改变管理儿科非粘性小肠阻塞的范式 - 我们应该做手术吗?
Tommy Kim1, Alyssa Stetson1, Cornelia Griggs1
1Massachusetts General Hospital, Department of Pediatric Surgery, Boston, Massachusetts.
The Journal of surgical research
|November 17, 2024
概括
儿科非粘性小肠阻塞 (NA-SBO) 的非手术治疗 (NOM) 是安全的,并且不会增加复发风险. 稳定的NA-SBO儿科患者可以考虑NOM,从而减少住院时间.
科学领域:
- 儿科手术 儿科手术
- 胃肠道手术 胃肠道手术
- 外科手术的结果
背景情况:
- 非手术治疗 (NOM) 对儿科粘性小肠阻塞 (A-SBO) 越来越成功.
- 对于非手术治疗的非粘性SBO (NA-SBO) 患者的小肠阻塞 (SBO) 潜在的重复发作存在担忧.
- 本研究探讨了NA-SBO的NOM与复发SBO的风险之间的关联.
研究的目的:
- 确定小儿科患者非手术治疗非粘性小肠阻塞 (NA-SBO) 是否会增加SBO复发的风险.
- 评估与NA-SBO非手术管理相关的发病率.
主要方法:
- 一个单一中心的观察研究,利用当前程序术语/国际疾病分类 (ICD) 代码和图表审查.
- 无粘性小肠阻塞 (NA-SBO) 被定义为SBO在没有SBO病史,腹部手术或已知的先天性胃肠异常的患者中.
- 排除标准包括监禁和瘤. 主要结局是SBO在一年内复发.
主要成果:
- 分析了97名患有NA-SBO的儿科患者队列;最初31%接受了手术.
- 在操作和非操作管理组之间没有观察到SBO在一年内复发率的显著差异 (6.7%与8.9%,P=0.70).
- 非手术治疗的患者的住院时间中位数较短 (2比7天,P<0.001),没有增加急诊室访问.
结论:
- 儿科非粘性小肠阻塞 (NA-SBO) 的非手术治疗与增加的SBO复发率无关.
- NA-SBO的NOM并没有导致患者发病率增加.
- 外科医生应考虑在NA-SBO呈现的稳定儿科患者的非手术治疗.
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