Serralta De Colsa Daniel, Arjona Medina Irene, García-Marín Andrés, Martín-Gil Jorge, Pérez-Díaz Maria Dolores, Turégano Fuentes Fernando
Servicio de Cirugía General y del Aparato Digestivo 2, Hospital General Universitario Gregorio Marañón, Madrid, España.
Cir Esp. 2009 Jun;85(6):348-53. doi: 10.1016/j.ciresp.2008.12.005. Epub 2009 Apr 1.
Ischaemic colitis (IC) is the most common form of bowel ischaemia and is often under-diagnosed.
To report the results obtained in patients with IC who required surgical intervention in our Hospital, and to evaluate the predictive factors of mortality.
The data were obtained from the Gregorio Marañon Hospital CI database. The demographic and clinical characteristics, diagnostic methods, surgical techniques employed and mortality were analysed statistically, using the chi(2) and Student t test.
One-hundred and one patients with CI were operated on between 1991 and 2006. The majority of them had cardiovascular histories and 35 cases were diagnosed during their hospital stay due to another cause. The signs and the symptoms were non-specific in 40% of the cases. Total morbidity and mortality was 39.6% and 41.6% respectively. In the post-operative IC cases, the death rate increased to 68% (p<0.01); 93% of the patients who died had transmural necrosis during the surgery (p<0.05) and 69% had a metabolic acidosis.
The death rate in patients with IC that requires surgery is high, particularly if the diagnosis is made in the post-operative period after surgery for another cause, or if there is evidence of transmural necrosis during the intervention. Early diagnosis is the best tool to improve these results.
缺血性结肠炎（IC）是肠道缺血最常见的形式，且常被漏诊。
报告我院需要手术干预的缺血性结肠炎患者的治疗结果，并评估死亡的预测因素。
数据来自格雷戈里奥·马拉尼翁医院的CI数据库。使用卡方检验和学生t检验对人口统计学和临床特征、诊断方法、所采用的手术技术及死亡率进行统计学分析。
1991年至2006年间，对101例患有CI的患者进行了手术。他们大多数有心血管病史，35例是在住院期间因其他原因被诊断出来的。40%的病例症状和体征不具特异性。总发病率和死亡率分别为39.6%和41.6%。在术后缺血性结肠炎病例中，死亡率升至68%（p<0.01）；93%的死亡患者在手术期间发生透壁坏死（p<0.05），69%的患者存在代谢性酸中毒。
需要手术治疗的缺血性结肠炎患者死亡率很高，尤其是在因其他原因手术后的术后阶段确诊，或在干预期间有透壁坏死证据的情况下。早期诊断是改善这些结果的最佳手段。
