结肠卷发症的管理和风险因素:回顾性国家队列研究
Suvi Rasilainen1, Mohamud Aden1, Antti J Kivelä1
1Department of Gastrointestinal Surgery, Abdominal Centre, Helsinki University Hospital and Helsinki University, Helsinki, Finland.
这项关于结肠卷发症管理的研究发现,手术比保守治疗提供更好的生存率,特别是在西格卷发症. 死亡的关键风险因素包括并发病和养老院住宿.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 结肠,一种导致肠道阻塞的疾病,需要有效的管理策略.
- 在国家队列中评估结果和风险因素对于改善患者护理至关重要.
研究的目的:
- 评估结肠卷发症管理的结果.
- 确定与结肠患者的发病率和死亡率相关的风险因素.
主要方法:
- 从2010年到2019年进行了一项多中心国家回顾性研究.
- 数据包括559名西格体卷发症患者和342名白内障卷发症患者.
- 用多变量回归和卡普兰-梅尔分析来确定死亡率预测因素.
主要成果:
- 对于西格体卷积,手术后30天死亡率为11.0%,保守治疗为19.0%. 一年死亡率为19.9% (手术) 和43.2% (保守).
- 对于白内障,30天和1年死亡率分别为6.4%和13.1%,手术是主要治疗方法.
- 死亡率的预测因素包括急诊手术,养老院住宿,增加并发症和西格体卷发症的男性性别;和并发症,养老院住宿和阴卷发症的死灰白.
结论:
- 在可行的情况下,建议对结肠卷发进行手术,同时考虑患者的并发症和偏好.
- 在内镜扭曲后的选择性sigmoidectomy提供了sigmoid volvulus的最低死亡风险.
- 结肠死,患者依赖和并发症是两种类型结肠卷发症死亡的重要预测因素.
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