三级护理中心成人肠套叠:一项回顾性研究。

Nigerian Journal of Surgery Pub Date : 2020-01-01 Epub Date: 2020-02-10 DOI:10.4103/njs.NJS_38_19
Sulfekar Meera Sainaba, Aravind S Ganapath, Anoop Sivakumar, A V Gayathri, I P Yadev
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引用次数: 2

摘要

背景:在成人中,大多数肠套叠病例是由恶性肿瘤引起的。目的:本研究的目的是描述在三级保健中心诊断和治疗的成人肠套叠的模式。研究设计:这是一项基于图表回顾的回顾性横断面研究,数据收集自计算机数据库和住院病例记录。研究背景:在印度南部三级保健转诊中心诊断和治疗的成人肠套叠病例。2012年8月至2016年7月期间所有诊断为肠套叠患者的住院病例表,包括调查和计算机数据库中的组织病理学信息,根据预测试和标准化表格进行撤回。人口统计数据和其他基线数据用描述性统计进行汇总。采用SPSS软件进行数据分析。结果:77例患者中,男性47例(61%)。常见表现为腹痛(95%)、呕吐(64%)和直肠出血(29%)。常见的检查结果是腹部压痛(45%),守卫(39%)和腹部肿块(38%)。超声检查,50例(65%)患者有肠套叠,以回肠结(25例)为最常见类型。28例(36%)患者行腹部计算机断层扫描,其中23例(82%)为肠套叠,以回肠结(9)为最常见类型。53例(69%)患者进行了手术,最常见的手术是右结肠切除术(25例),然后是小肠切除术和吻合(23例)。术中42例(79%)患者出现肠套叠,以回结肠肠套叠(23例)最为常见。术中14例(26%)患者出现肠坏疽。活检证实46例患者出现肠套叠,其中恶性肿瘤(21例)是最常见的原因。患者接受定期随访。6例小肠肠套叠合并息肉病患者发生肠套叠复发。结论:成人肠套叠常伴有恶性肿瘤。因此,需要进行不复位的正式切除,并应遵循肿瘤学原则进行手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Adult Intussusception at a Tertiary Care Center: A Retrospective Study.

Background: In adults, the majority of cases of intussusception are due to malignancy.

Aims: The aim of the study is to describe the pattern of intussusception in the adult population diagnosed and treated at a tertiary care center.

Subjects and methods: Study Design: This is a retrospective cross-sectional study based on chart review, and data collection was made from the computer database and inpatient case records. Study Setting: Adult intussusception cases diagnosed and treated at a tertiary care referral center in South India. All inpatient case sheets including investigations and histopathology information on the computer database of all patients diagnosed with intussusception in the period of August 2012 to July 2016 were retracted based on a pretested and standardized form. Demographic data and other baseline data were summarized with descriptive statistics. SPSS software was used for data analysis.

Results: Of the 77 patients, 47 (61%) were male. The common presentations were abdominal pain (95%), vomiting (64%), and rectal bleeding (29%). Common examination findings were abdominal tenderness (45%), guarding (39%), and abdominal mass (38%). On ultrasonography, fifty (65%) patients had intussusception with ileocolic (25) as the most common type. Computed tomography abdomen was taken for 28 (36%) patients, in which 23 (82%) had intussusception with ileocolic (9) as the most common type. Surgery was done for 53 (69%) patients, and the most common procedure was right hemicolectomy (25) followed by resection and anastomosis of the small bowel (23). Intraoperatively, 42 (79%) patients had intussusception with ileocolic (23) as the most common type. Intraoperatively, 14 (26%) patients had a bowel gangrene. Biopsy-proven cause for intussusception was present in 46 patients, with malignancy (21) as the most common cause. The patients were on regular follow-up. Recurrence of intussusception occurred in six patients of the small bowel intussusception who had polyposis.

Conclusions: Adult intussusception is often associated with malignancy. Hence, a formal resection without reduction is needed and surgery should be done following oncological principles.

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