[重症急性胰腺炎患者肠功能不全综合征与外肠瘘发生风险的关系]。

Q4 Medicine
V V Kiselev, M S Zhigalova, P A Yartsev, S V Novikov, A M Kuzmin, D T Tkeshelashvili
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引用次数: 0

摘要

目的:探讨重症急性胰腺炎(SAP)合并胰腺坏死患者发生外肠瘘的危险因素。材料与方法:回顾性和前瞻性研究纳入537例SAP患者,其中男性354例(65.9%),女性183例(34.1%),平均年龄51.2±18.5岁。为评价强化治疗的效果,将患者分为两组。对照组(n=207)包括根据国家指南《急性胰腺炎》(2020)接受检查和治疗的患者。主组(n=330)在原方案的基础上进行检查和治疗。p:肠衰竭评分< 5的患者无脓毒性并发症及多脏器功能衰竭。在6-9分的患者中,脓毒性并发症占11.7%,多器官功能衰竭占14.8%。在10-12分的患者中,脓毒性并发症发生率为24.6%,多器官功能衰竭发生率为30%。因此,肠衰竭评分bbbb10是脓毒性并发症和多器官衰竭的重要预后标准。此外,8.5分肠衰竭患者发生外肠瘘。p: SAP合并胰腺坏死患者肠衰竭的进展与脓毒性并发症和外肠瘘相关。原始的诊断算法对早期发现功能性胃肠疾病、严重程度和这些变化的定位有价值。独创的评分系统可以预测患者入院第一天发生脓毒性并发症和多器官功能衰竭的风险。此外,及时的治疗改善了SAP患者的治疗结果。在我们的研究中,主要组脓毒性并发症包括肠外瘘的发生率从10%下降到7%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Relationship between intestinal insufficiency syndrome and risk of external intestinal fistulas in patients with severe acute pancreatitis].

Objective: To identify the risk factors of external intestinal fistulas in patients with severe acute pancreatitis (SAP) and pancreatic necrosis.

Material and methods: A retrospective and prospective study included 537 patients (354 (65.9%) men and 183 (34.1%) women) with SAP. Mean age was 51.2±18.5 years. To assess the effectiveness of intensive therapy, patients were divided into 2 groups. The control group (n=207) included patients who underwent examination and treatment according to the national guidelines «Acute pancreatitis», 2020). In the main group (n=330), examination and treatment were supplemented with original protocol.

Results. p: Atients with intestinal failure score< 5 had no purulent-septic complications and multiple organ failure. Among patients with 6-9 scores, purulent-septic complications were observed in 11.7% of cases, multiple organ failure - 14.8% of cases. Among patients with 10-12 scores, the incidence of purulent-septic complications was 24.6%, multiple organ failure - 30% of cases. Thus, intestinal failure score > 10 is an important prognostic criterion of purulent-septic complications and multiple organ failure. In addition, external intestinal fistulas occurred in 8.5% of patients with intestinal failure score > 10.

Conclusion. p: Rogression of intestinal failure correlates with purulent-septic complications and external intestinal fistulas in patients with SAP and pancreatic necrosis. Original diagnostic algorithm is valuable for early detection of functional gastrointestinal disorders, severity and localization of these changes. Original scoring system makes it possible to predict the risk of purulent-septic complications and multiple organ failure on the first day after admission. Moreover, timely therapy improves treatment outcomes in patients with SAP. In our study, the incidence of purulent-septic complications including external intestinal fistulas decreased from 10% to 7% in the main group.

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来源期刊
Khirurgiya
Khirurgiya Medicine-Medicine (all)
CiteScore
0.70
自引率
0.00%
发文量
161
期刊介绍: Хирургия отдельных областей сердце, сосуды легкие пищевод молочная железа желудок и двенадцатиперстная кишка кишечник желчевыводящие пути печень
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