预测转换以量身定制患者期望和在克罗恩病的骨髓切除术中的术后疼痛管理
Michele Carvello1,2, Annalisa Maroli2, Dakshita Wickramasinghe3
1Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4Pieve Emanuele, 20090, Milan, Italy.
Updates in surgery
|April 23, 2025
概括
对于克罗恩氏病 (CD) 转换为开放性手术的最小侵入性手术,男性性别,BMI,多种疾病部位,腹/穿孔和之前的手术预测. 一个新的风险评分有助于患者咨询和术后护理.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床流行病学 临床流行病学
背景情况:
- 最少侵入性手术 (MIS) 首选用于克罗恩病 (CD),但可以转换为开放式手术.
- 识别转换的风险因素对于患者管理和手术规划至关重要.
研究的目的:
- 在接受CD的MIS患者中,确定转换为开放手术的独立风险因素.
- 开发和验证用于转换风险的预测评分系统.
主要方法:
- 在两个欧洲中心,从309名接受CDMIS的患者回顾性数据收集.
- 后勤回归分析以确定风险因素并制定预测得分.
- 接收器操作特征 (ROC) 曲线分析以评估得分的性能 (AUC).
主要成果:
- 转换为开放性手术发生在21%的患者中.
- 转换的独立风险因素包括男性性别,较高的BMI,手术前多种疾病局部化,腹/穿孔和之前的CD手术.
- 开发的风险评分显示出良好的预测性能,AUC为0.80.
结论:
- 男性的性别,BMI,疾病程度/严重程度和手术史是从MIS转换到CD开放手术的重要预测因素.
- 开发的预测得分可以帮助患者咨询,并优化CD中大肠切除的术后护理.
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