Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung, 80756, Taiwan.
World J Surg. 2010 Oct;34(10):2383-8. doi: 10.1007/s00268-010-0646-6.
The aim of this study was to identify the preoperative factors that affect the survival of patients who undergo esophagogastrectomy after corrosive ingestion, using analysis of their physiological condition, associated diseases, physical examination, and laboratory data.
Between January 1995 and December 2005, 71 consecutive patients who underwent esophagogastrectomy for corrosive ingestion injuries were retrospectively reviewed. Of them, 41 survived and 30 (42.3%) died during the perioperative period. Logistic regression analyses were used to model markers for postoperative mortality, including descriptive data, clinical symptoms/signs, and laboratory data.
There were 35 males and 36 females included in the study, with an average age of 54.7 +/- 14.9 years. After adjustments in the logistic regression model, age of over 65 years (p = 0.021), presence of gross hematuria (p = 0.016), twofold level of serum AST (p = 0.012), blood pH level below 7.2 (p = 0.017), and deficit of blood base over 16 (p = 0.007) were found to be independent risk factors for patient mortality.
We consider age over 65 years, preoperative pH < 7.2, base deficit >16, twofold level of serum AST, and presence of gross hematuria to be the important factors predicting postoperative hospital mortality in patients presenting with corrosive ingestion injuries who require emergency surgery.
本研究旨在通过分析患者生理状况、合并疾病、体格检查和实验室数据，确定腐蚀性摄入后接受食管胃切除术患者的生存的术前影响因素。
1995 年 1 月至 2005 年 12 月，回顾性分析了 71 例因腐蚀性摄入损伤而行食管胃切除术的连续患者。其中，41 例存活，30 例（42.3%）围手术期死亡。采用逻辑回归分析对术后死亡率的标志物进行建模，包括描述性数据、临床症状/体征和实验室数据。
本研究纳入 35 例男性和 36 例女性患者，平均年龄为 54.7±14.9 岁。在逻辑回归模型调整后，年龄>65 岁（p=0.021）、肉眼血尿（p=0.016）、血清 AST 水平升高两倍（p=0.012）、pH 值<7.2（p=0.017）和血碱缺失>16（p=0.007）被认为是患者死亡的独立危险因素。
我们认为年龄>65 岁、术前 pH 值<7.2、碱缺失>16、血清 AST 水平升高两倍和肉眼血尿是预测腐蚀性摄入损伤患者需要紧急手术的术后住院死亡率的重要因素。
