在Clostridioides困难结肠炎中,转向环结肠切除术与前级结肠冲洗相比,与结肠切除术相比:十年的倾向性得分匹配分析
Bardiya Zangbar1, Riddhi Mehta, Jordan Kirsch
1From the Department of Trauma and Acute Care Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.
The journal of trauma and acute care surgery
|February 18, 2026
概括
转向循环结肠切除术与前级结肠冲洗 (DLI) 是一种安全的结肠保护选择,用于 fulminant Clostridioides difficile colitis (CDC),显示减少伤口并发症而不会影响生存率.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
背景情况:
- Fulminant Clostridioides 艰难大肠炎 (CDC) 具有显著的发病率和死亡率风险.
- 整体腹腔切除术 (TAC) 是标准的手术治疗.
- 转向循环结肠切除术与前级结肠洗 (DLI) 提供了一种结肠保护的替代方案.
研究的目的:
- 将DLI和CDC的TAC之间的结果进行比较.
- 评估DLI-first方法的安全性和有效性.
- 分析需要从DLI转换为TAC的患者的结果.
主要方法:
- 从国家住院患者样本中对成年CDC患者 (2012-2021) 的回顾性分析.
- 排除患有腹腔综合征或穿孔的患者.
- 倾向性得分匹配 (1:1) 对于人口和并发症调整.
主要成果:
- 在DLI和TAC组之间的死亡率没有显著差异 (24.4%与26.0%).
- DLI与下部术后伤口并发症相关 (p < 0.05).
- 需要转换为TAC的失败的DLI案件显示了与初级TAC后匹配结果相似的结果.
结论:
- DLI是一种安全的,选择性的TAC替代品,可供选择的疾病预防控制中心患者使用.
- 在不影响生存的情况下,DLI可降低伤口发病率.
- 选择性DLI使用支持结肠保护性手术策略.
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