肠瘘合并腹腔出血危险因素及其预后分析

发布时间：2018-03-31 11:01

本文选题：肠瘘　切入点：腹腔出血　出处：《中国实用外科杂志》2016年10期

【摘要】：目的探讨肠瘘病人并发腹腔出血的危险因素,评价腹腔出血对肠瘘病人预后的影响。方法回顾性分析南京大学医学院附属金陵医院普通外科2013年10月至2015年10月201例肠瘘病人的临床资料,其中67例病人住院期间出现腹腔出血(并发出血组),134例病人住院期间未出现腹腔出血(未并发出血组),分析腹腔出血的风险因素及预后情况。结果 logistic回归提示十二指肠瘘(OR 3.348,95%CI 1.215~9.231,P=0.019)、入院前腹腔出血史(OR 10.698,95%CI 4.447~25.737,P0.001)及急性肾损伤(OR 6.090,95%CI 2.408~15.405,P0.001)是肠瘘病人并发腹腔出血的独立危险因素。与未合并出血组相比,合并出血组病死率明显较高,肠外营养时间,重症监护室住院天数明显延长,相关并发症的发生率及住院费用明显较高(P0.05)。结论十二指肠瘘、人院前腹腔出血病史及合并急性肾功能损伤是肠瘘并发腹腔出血的独立危险因素。肠瘘合并腹腔出血病情凶险,病死率高,病人预后较差。
[Abstract]:Objective to investigate the patients complicated with intra-abdominal hemorrhage risk factors affecting intestinal fistula, evaluate the prognosis for patients with intestinal fistula intra-abdominal hemorrhage. Methods retrospectively analyze clinical data of the Affiliated Hospital of Medical College of Nanjing University Jinling general surgery from October 2013 to October 2015, 201 cases with intestinal fistula, 67 cases of hospitalized patients during the abdominal hemorrhage (bleeding group), 134 cases of inpatients no abdominal hemorrhage (non bleeding group), and prognosis analysis of risk factors of intra-abdominal hemorrhage. The results of logistic regression analysis indicated that duodenal fistula (OR 3.348,95%CI 1.215~9.231, P =0.019), before admission abdominal bleeding history (OR 10.698,95%CI 4.447~25.737, P0.001) and acute kidney injury (OR 6.090,95%CI, 2.408~15.405, P0.001) were independent risk patients intraperitoneal bleeding fistula factors. Compared with non bleeding group, mortality rate was significantly higher with hemorrhage, parenteral nutrition Between ICU hospitalization days and hospitalization expenses, the incidence of complications was significantly higher (P0.05). Conclusion duodenal fistula, abdominal hemorrhage and pre hospital with acute renal injury complicated with intra-abdominal hemorrhage were independent risk factors of intestinal fistula and intestinal fistula. Intraperitoneal hemorrhage dangerous disease, high mortality rate, prognosis poor.

【作者单位】：南京大学医学院附属金陵医院普通外科研究所;
【基金】：国家自然科学基金(No.81270478)
【分类号】：R656

【相似文献】