Background Although the indication controversial, our experience of surgical patients. and the timing for surgery in fulminant treatment for fulminant acute pancreatitis acute pancreatitis （FAP） are still may help i...Background Although the indication controversial, our experience of surgical patients. and the timing for surgery in fulminant treatment for fulminant acute pancreatitis acute pancreatitis （FAP） are still may help improve the outcome for Methods The clinical data of twenty-six patients with FAP from January 1, 2001 to October 1, 2005 were analyzed. The diagnostic criteria fitted the 2007 Guidelines for the Management of Severe Acute Pancreatitis by the Chinese Medical Association. Results Twenty-six patients with FAP received surgical debridement, with a mortality rate of 42.3% （11/26）. The postoperative mortalities in the 〉72 hour operation group and the 〈72 hour operation group were highly significantly different （7/8 vs 22.2% （4/18）, respectively）. Conclusions Early surgery may reduce the intraabdominal pressure and prevent the deterioration of FAP. An operation within 72 hours from the onset of symptoms might decrease the mortality of the disease.展开更多
目的研究绞窄性肠梗阻的危险因素以及手术时机选择与手术效果的关系。方法将2010年1月至2013年10月绵阳市中心医院普外科收治的肠梗阻患者纳入研究,根据手术时机不同分为绞窄性肠梗阻组（78例）和单纯性肠梗阻组（92例）,分析早期诊断指...目的研究绞窄性肠梗阻的危险因素以及手术时机选择与手术效果的关系。方法将2010年1月至2013年10月绵阳市中心医院普外科收治的肠梗阻患者纳入研究,根据手术时机不同分为绞窄性肠梗阻组（78例）和单纯性肠梗阻组（92例）,分析早期诊断指标,观察术后恢复情况。结果体温高（OR=2.948,95%CI 1.878-4.232）、心率快（OR=3.485,95%CI 2.482-4.785）、腹痛持续时间长（OR=2.452,95%CI 1.285-3.523）、腹膜刺激征（OR=7.875,95%CI 6.447-9.457）、C反应蛋白（OR=3.445,95%CI 2.270-4.795）、白细胞介素1（OR=11.477,95%CI 9.587-13.237）和白细胞介素6水平高（OR=9.423,95%CI 7.849-10.899）、腹部手术史（OR=13.594,95%CI 3.104-5.423）是绞窄性肠梗阻发生的危险因素（P〈0.05）。单纯性肠梗阻患者术后肛门排气时间、卧床时间显著低于绞窄性肠梗阻患者[（1.9±0.4）d比（3.4±0.7）d,（4.8±0.8）d比（7.4±1.1）d,P〈0.05]。单纯性肠梗阻患者术后1 d数字评价量表（NRS）评分为（2.8±0.5）分、术后3 d NRS疼痛评分（1.9±0.3）分、术后5 d NRS疼痛评分（1.2±0.2）分,绞窄性肠梗阻患者术后1 d NRS评分（4.8±0.7）分、术后3 d NRS疼痛评分（4.1±0.6）分、术后5 d NRS疼痛评分（2.7±0.5）分,单纯性肠梗阻患者与绞窄性肠梗阻患者治疗前后与处理存在交互作用（均P〈0.05）。结论腹膜刺激征、白细胞介素1和白细胞介素6水平可作为判断和预测绞窄性肠梗阻的可靠指标,指导早期诊断、及时手术,改善患者预后。展开更多
文摘Background Although the indication controversial, our experience of surgical patients. and the timing for surgery in fulminant treatment for fulminant acute pancreatitis acute pancreatitis （FAP） are still may help improve the outcome for Methods The clinical data of twenty-six patients with FAP from January 1, 2001 to October 1, 2005 were analyzed. The diagnostic criteria fitted the 2007 Guidelines for the Management of Severe Acute Pancreatitis by the Chinese Medical Association. Results Twenty-six patients with FAP received surgical debridement, with a mortality rate of 42.3% （11/26）. The postoperative mortalities in the 〉72 hour operation group and the 〈72 hour operation group were highly significantly different （7/8 vs 22.2% （4/18）, respectively）. Conclusions Early surgery may reduce the intraabdominal pressure and prevent the deterioration of FAP. An operation within 72 hours from the onset of symptoms might decrease the mortality of the disease.
文摘目的研究绞窄性肠梗阻的危险因素以及手术时机选择与手术效果的关系。方法将2010年1月至2013年10月绵阳市中心医院普外科收治的肠梗阻患者纳入研究,根据手术时机不同分为绞窄性肠梗阻组（78例）和单纯性肠梗阻组（92例）,分析早期诊断指标,观察术后恢复情况。结果体温高（OR=2.948,95%CI 1.878-4.232）、心率快（OR=3.485,95%CI 2.482-4.785）、腹痛持续时间长（OR=2.452,95%CI 1.285-3.523）、腹膜刺激征（OR=7.875,95%CI 6.447-9.457）、C反应蛋白（OR=3.445,95%CI 2.270-4.795）、白细胞介素1（OR=11.477,95%CI 9.587-13.237）和白细胞介素6水平高（OR=9.423,95%CI 7.849-10.899）、腹部手术史（OR=13.594,95%CI 3.104-5.423）是绞窄性肠梗阻发生的危险因素（P〈0.05）。单纯性肠梗阻患者术后肛门排气时间、卧床时间显著低于绞窄性肠梗阻患者[（1.9±0.4）d比（3.4±0.7）d,（4.8±0.8）d比（7.4±1.1）d,P〈0.05]。单纯性肠梗阻患者术后1 d数字评价量表（NRS）评分为（2.8±0.5）分、术后3 d NRS疼痛评分（1.9±0.3）分、术后5 d NRS疼痛评分（1.2±0.2）分,绞窄性肠梗阻患者术后1 d NRS评分（4.8±0.7）分、术后3 d NRS疼痛评分（4.1±0.6）分、术后5 d NRS疼痛评分（2.7±0.5）分,单纯性肠梗阻患者与绞窄性肠梗阻患者治疗前后与处理存在交互作用（均P〈0.05）。结论腹膜刺激征、白细胞介素1和白细胞介素6水平可作为判断和预测绞窄性肠梗阻的可靠指标,指导早期诊断、及时手术,改善患者预后。
