早期手术或粘性小肠阻塞的保守管理:对短期和长期结果的全面系统审查
Fahd Al Abbood1, Omar Altamimi2, Ibrahim Altamimi3
1General Surgery, Saudi Board of General Surgery, King Salman Hospital, Riyadh, SAU.
Cureus
|January 21, 2026
概括
非手术管理 (NOM) 是安全的稳定成年人粘性小肠阻塞 (aSBO),但早期手术减少长期复发的40-60%. 延迟NOM失败会增加并发症,特别是在婴儿中.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 系统审查是系统的审查.
背景情况:
- 粘性小肠阻塞 (aSBO) 是紧急手术入院的常见原因.
- 对aSBO的最佳初始管理 (早期手术与非手术管理 (NOM)) 进行了辩论,特别是关于复发和安全.
研究的目的:
- 系统地审查和比较早期手术管理的短期和长期结果与aSBO在成人和儿科患者中保守的NOM.
主要方法:
- 按照PRISMA指南,对MEDLINE,Embase,Scopus和Cochrane CENTRAL进行系统搜索 (开始至2025年).
- 包括九项评估成人和儿科aSBO患者结局的研究.
主要成果:
- 在稳定的成年人中,NOM的短期安全性与早期手术相比较,但NOM失败后的延迟增加了发病率和肠切除.
- 与NOM相比,早期的操作管理显示,长期复发的相对减少率为40-60%.
- 水溶性对比度和特定的放射学发现改善了NOM成功和失败的预测.
- 在儿科患者中,NOM是有效的,但婴儿<1年和延迟>48小时增加了手术和切除率.
结论:
- 对于一些患有aSBO的成年患者来说,NOM是一个安全的选择.
- 早期的外科干预提供了优越的长期结果,特别是SBO的复发率降低.
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