瘤外科紧急情况的临床特征和结果:回顾性研究
Ling Chen1, Lingqiang Min1, Qiangjun Gan1
1Department of Acute Care Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
Annals of surgical oncology
|August 21, 2025
概括
癌症外科紧急情况的新五类分类有效指导临床决策. 这种系统有助于管理其他紧急情况的死亡率.
科学领域:
- 癌症学
- 手术应急管理
- 临床分类系统
背景情况:
- 由于癌症发病率上升和患者生存率提高,癌症外科紧急情况 (OSEs) 正在增加.
- 之前关于OSE的研究缺乏全面的重点.
- 需要有效的临床决策工具.
研究的目的:
- 确定OSE的五类分类是否可以有效指导临床决策.
- 根据建议的OSE分类来分析患者的结果.
- 建立一个管理OSE的框架.
主要方法:
- 使用前性收集数据的回顾性队列研究 (2015年5月 - 2023年12月).
- 包括2908名接受紧急整体手术的OSE住院患者.
- 根据瘤的发展过程将OSEs分为五类:初始呈现,进展/复发,非侵入性治疗并发症,侵入性治疗并发症以及与恶性瘤史无关的紧急情况.
主要成果:
- 阻塞是最常见的紧急情况 (58.0%),主要来自胃肠道瘤 (79.8%).
- 第1类 (初始症状) 是最常见的 (42. 8%),其次是第5类 (19. 5%),第4类 (16. 0%),第2类 (16. 4%) 和第3类 (5. 5%).
- 与其他紧急情况相比,OSE患者的住院死亡率较高 (4. 0%),为1. 5%;p < 0. 001). 穿孔,65岁以上和男性性别是独立的风险因素.
结论:
- 一个全面的五类分类系统为OSE提供了一个有价值的临床决策框架.
- 这种分类系统可以指导OSE患者的治疗策略.
- 拟议的分类有可能融入临床实践.
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