摘要
目的 :探讨腹部手术后粘连性肠梗阻再手术指征的预测指标。方法 :采用χ2检验及多因素Logistic回归方法,对2007年1月至2014年1月我院普外科269例腹部手术后粘连性肠梗阻病人临床资料进行回顾性分析。结果:单因素分析显示,发热、CT检查显示肠壁不强化或弱强化、防粘连药应用等因素与粘连性肠梗阻手术密切相关。多因素非条件Logistic回归分析表明,发热(X1)、肠壁不强化或弱强化(X2)、肠壁增厚(X3)、腹膜刺激征(X4)、开腹手术(X5)、防粘连药应用(X6)是有意义的指标。得到的预测模型为:P=ex/(1+ex),x=-1.488X1+1.453X2+0.825X3+1.750X4+1.324X5-1.151X6。结论:对于腹部手术后粘连性肠梗阻病人,由发热、CT检查显示肠壁不强化或弱强化及肠壁增厚、腹膜刺激征、手术方式、防粘连药应用因素所建立的Logistic回归模型,可能有助于判断腹部手术后粘连性肠梗阻是否需要手术治疗。
Objective To explore the indications for reoperative of the patients with adhesive ileus after abdominal surgery. Methods The data of 269 patients with adhesive ileus after abdominal surgery in our hospital from January 2007 to January 2014 were reviewed. The univariate analysis was done using chi-squared tests. Logistic regression model was performed in this study. Results The univariate analysis showed that reoperation of the patients with adhesion ileus was associated with fever（X1）, without or weak strengthening（X2） and thickening of intestinal wall（X3） in CT scanning, peritoneal irritation（X4）, open surgery（X5） and anti-adhesive drug（X6）. All 6 positive results from univariate analysis were conformed by multiple unconditioned Logistic regression analyses. The model was P=ex/（1＋ex）, x=-1.488X1＋1.453X2＋0.825X3＋1.750X4＋ 1.324X5-1.151X6. Conclusions The Logistic regression model consisted of 6 indicators including fever, without or weak strengthening and thickening of intestinal wall in CT examination scanning, peritoneal irritation, open surgery and antiadhesive drug can be helpful for determining whether reoperation is needed for the patients with adhesion ileus after abdominal surgery.
出处
《外科理论与实践》
2015年第5期444-446,共3页
Journal of Surgery Concepts & Practice
基金
浦东新区卫生和计划生育委员会卫生科技项目(NKYL0517)
关键词
术后粘连性肠梗阻
手术指征
预测指标
Postoperative adhesive intestinal obstruction
Surgical indication
Predictor
