粘连性小肠梗阻患者肠缺血的预测

M. K. Gulov, J. S. Salimov, J. K. Mukhabbatov, S. Ali-Zade, K. N. Nosiri
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摘要

的目标。目的:探讨急性粘连性小肠梗阻患者肠缺血的诊断方法。本文对124例急性粘连性小肠梗阻患者进行了研究。采用Logistic回归分析确定肠缺血最重要的预后因素。将所得回归系数指标应用于评分系统。确定了六个独立的肠缺血预后因素:年龄,疼痛持续时间,体温,白细胞计数,肠壁造影剂降低,以及CT扫描可见的局部肠系膜水肿。回归系数得分归为与肠缺血相关的每个变量。预测肠缺血的发生是用0到24分的总和来计算的。采用6分的阈值来定义低概率组(肠缺血风险为1.13%)。得分在7到15分之间确定为中等概率组(肠缺血的风险为44%)。评分≥16分为高概率组(该组患者均有肠缺血)。肠缺血风险预测评估准确率高(90%以上)。该评价可靠、可重复性好,可帮助外科医生区分肠缺血患者进行手术干预。由于缺血性疾病可能是可逆的,这可以防止肠坏死的发展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predicting of intestinal ischemia in patients with adhesive small bowel obstruction
Aim. To detect intestinal ischemia promptly in patients with acute adhesive small bowel obstruction.Methods. A total of 124 patients with acute adhesive small bowel obstruction were studied. Logistic regression analysis was performed to determine the most significant prognostic factors for intestinal ischemia. The derived regression coefficient indicators were utilized in a scoring system.Results. Six independent prognostic factors of intestinal ischemia were identified: age, duration of pain, body temperature, white blood cell count, reduced intestinal wall contrast, and localized mesenteric edema visible on a CT scan. Regression coefficient scores were attributed to each variable associated with intestinal ischemia. The predicted occurrence of bowel ischemia was computed as a sum of scores ranging from 0 to 24. A threshold of 6 points was used to define the low-probability group (risk of bowel ischemia was 1.13%). A score between 7 and 15 determined the intermediate-probability group (the risk of intestinal ischemia was 44%). A score of ≥16 defined the high-probability group (all patients in this group had intestinal ischemia).Conclusions. The risk prediction assessment of bowel ischemia was performed with high accuracy (above 90%). This evaluation is reliable and reproducible, hence it may aid the surgeon to differentiate patients with intestinal ischemia for surgical intervention. Since ischemic disorders may be reversible, this could prevent the development of intestinal necrosis.
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