上部胃肠道穿孔的预后风险因素:身体组成参数的作用
Teng Zhu1,2, Huayan Gu3, Yuefeng Chen1,2
1Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Frontiers in nutrition
|September 22, 2025
概括
确定上部胃肠道穿孔不良结果的预测因素至关重要. 低肌肉储备,高内脏脂肪和高血小板-淋巴细胞比率是预后不佳的关键指标.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 预测性的生物标志物
背景情况:
- 上部胃肠道穿孔是一个重大的挑战,尽管医学进步,但其预后历来一直很差.
- 确定预测不良结果的关键因素对于改善患者管理至关重要.
研究的目的:
- 为了确定诊断上部胃肠道穿孔的患者不良后果的预测因素.
- 分析各种临床和实验室参数与患者预后之间的关联.
主要方法:
- 对200名胃肠上部穿孔患者的实验室数据进行了回顾性分析.
- 根据结果对患者进行分类,包括败血性休克,重症监护室 (ICU) 住院和术后并发症.
- 进行单变量和多变量分析以确定预后因素.
主要成果:
- 低肌肉储备,高内脏脂肪面积 (VFA) 和高血小板与淋巴细胞比率 (PLR) 预测了败血症休克.
- 影响ICU入院的因素包括性别,高VFA,延长的前血红素时间 (PT) 和升高的D-二次数水平.
- 手术方法,最大穿孔直径和白细胞 (WBC) 数量与术后并发症有关.
结论:
- 该研究确定了上部胃肠道穿孔的几种预后因素.
- 关键预测因素包括低肌肉储备,高VFA,PLR,性别,PT,D-二次数,手术方法,白细胞计数和穿孔大小.
- 这些发现可以帮助风险分层和个性化患者护理.
相关概念视频
Esophageal Perforation-I: Introduction
418
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
418
Esophageal Perforation-II: Clinical Manifestations and Management
505
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
505
Peptic Ulcer Disease I: Introduction
745
Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
745
Inflammatory Bowel Disease II: Crohn's Disease
960
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
960
Peptic Ulcer Disease V: Surgical Management and Nursing Care
830
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
830
Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors
1.1K
Peptic ulcer disease, commonly called PUD, represents a multifaceted condition characterized by disruptions in the lining of the gastrointestinal (GI) tract. Central to the protection of the gastrointestinal lining is the mucosal-bicarbonate barrier. This physiological defense mechanism is a formidable shield against the corrosive effects of gastric acid and pepsin secretion in the stomach. Its role is pivotal in maintaining the structural integrity of the stomach's inner lining.
1.1K


