与住院治疗或腹痛手术相关的因素:一项回顾性研究
Hélène Bréchet1,2, Hélène Vanquaethem2, Raphaële Mestiri2
1Emergency Department, Bégin Military Teaching Hospital, Saint-Mandé, France.
区分严重和良性急性腹痛 (AAP) 是一个挑战. 住院或手术的关键指标包括右下沟疼痛,腹部保护,中性恋,升高的脂酶和CRP水平.
科学领域:
- 紧急医疗 紧急医疗
- 胃肠病学 胃肠病学
- 外科评估的评估.
背景情况:
- 急性腹痛 (AAP) 占紧急诊所访问的很大一部分.
- 区分AAP的严重和良性原因是一个临床挑战.
- 确定住院或紧急手术的预测因素对于患者管理至关重要.
研究的目的:
- 在患有AAP的患者中确定与住院或紧急手术相关的因素.
- 分析临床,实验室和成像数据以获得预测价值.
主要方法:
- 一个单一中心的回顾性观察性研究,涉及2201名AAP患者.
- 从医疗记录中分析了86个因素,比较住院/手术治疗的患者和出院的患者.
- 多变量分析以确定独立的预测因素.
主要成果:
- 五个因素独立地与住院/手术相关:右下腔疼痛,腹部保护,中性恋,血清脂酶>3x ULN,CRP>6 mg/L.
- 腹部CT扫描结果也与当前住院/手术有很强的关联.
- 血清脂酶升高显示,住院/手术的几率比率 (26.4) 特别高.
结论:
- 腹部保护,中性恋和升高的CRP对于区分严重和良性AAP有价值.
- 右下腔疼痛位置和血清脂酶升高与住院或紧急手术的可能性增加有关.
- 在同质的患者群体中进行进一步的研究可能会为AAP严重性评估提供有用的评分系统.
更多相关视频
09:00Application of Straight-needle, Three-tailed, Knot-free, Peritoneal Sutures in Laparoscopic Transabdominal Preperitoneal Hernia Repair
Published on: November 12, 2021
07:36Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
相关概念视频
Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Abdominal Regions and Quadrants
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four...
Acute Pancreatitis II: Clinical Manifestations and Management
