在西格莫伊德卷发症管理的模两可:开发一个最佳管理策略的框架
Meghana Taggarsi1, Sunetra Chaterjee1, Anil Kumar1
1Colorectal and General Surgery, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust, Boston, GBR.
Cureus
|January 8, 2026
概括
制定了西格性卷发症 (SV) 管理指南,强调早期手术以减少高复发率和医疗保健成本. 这种方法将手术干预与并发症评估相结合,以获得最佳的患者结果.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 外科胃肠道外科手术
- 结肠直肠手术 结肠直肠手术
背景情况:
- 西格体卷发症 (SV) 是大肠阻塞的重要原因,通常通过内镜进行管理.
- 在内镜解压后的高复发率 (45-71%) 在最终的治疗策略中产生了模两可.
- 目前的管理层缺乏明确的指导方针来选择选择性手术和重复性内镜干预.
研究的目的:
- 在英国国家卫生服务 (NHS) 信托机构中制定基于证据的指导方针,用于对西格体卷发症的管理.
- 评估当前管理策略的有效性,并确定影响复发和结果的因素.
- 为最佳决策提供一个框架,关于手术干预与保守管理的最佳决策.
主要方法:
- 这是一项回顾性研究,分析了三年来42名西格体卷发症患者的数据.
- 数据收集包括诊断方式 (AXR,CT),内解压成功率,并发症 (CCI) 和复发率.
- 使用卡普兰-梅尔分析来评估无复发生存率.
主要成果:
- 大多数患者 (76.2%) 患有中度至重度的并发症.
- 在所有病例中,内镜解压都是成功的,但35.7%的病例复发,通常在90天内.
- 只有11.9%的患者接受了最终的手术,通常是在多次复发后进行的,这表明手术考虑的潜在延迟.
结论:
- 制定地方指导方针,以加快 SV 管理,与国际建议保持一致.
- 倡导整体方法,将早期手术干预与并发症评估整合起来.
- 早期的手术决定可以显著减少复发,再入院,发病率和相关的医疗保健成本.
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