高急性生理与慢性健康评分和长肠切除范围会影响坏疽性肠病合并门静脉积气患者的预后。
High APACHE II score and long length of bowel resection impair the outcomes in patients with necrotic bowel induced hepatic portal venous gas.
机构信息
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
出版信息
BMC Gastroenterol. 2011 Mar 9;11:18. doi: 10.1186/1471-230X-11-18.
BACKGROUND
Hepatic portal venous gas (HPVG) is a rare but potentially lethal condition, especially when it results from intestinal ischemia. Since the literatures regarding the prognostic factors of HPVG are still scarce, we aimed to investigate the risk factor of perioperative mortality in this study.
METHODS
We analyzed data for patients with intestinal ischemia induced HPVG by chart review in our hospital between 2000 and 2007. Factors associated with perioperative mortality were specifically analyzed.
RESULTS
There were 22 consecutive patients receiving definite bowel resection. 13 cases (59.1%) died after surgical intervention. When analyzing the mortality in patients after bowel resections, high Acute Physiology And Chronic health Evaluation (APACHE) II score (p<0.01) and longer length of bowel resection (p=0.047) were significantly associated with mortality in univariate analyses. The complication rate was 66.7% in alive patients after definite bowel resection.
CONCLUSIONS
Bowel resection was the only potential life-saving therapy for patients with mesenteric ischemia induced HPVG. High APACHE II score and severity of underlying necrotic bowel determined the results in patients after bowel resection.
背景
肝门静脉积气（HPVG）是一种罕见但潜在致命的疾病，尤其是当它是由肠缺血引起的。由于关于 HPVG 的预后因素的文献仍然很少，我们旨在研究本研究中 HPVG 的围手术期死亡率的危险因素。
方法
我们通过对 2000 年至 2007 年我院肠缺血性 HPVG 患者的图表回顾分析了数据。特别分析了与围手术期死亡率相关的因素。
结果
有 22 例连续接受明确肠切除术的患者。手术后 13 例（59.1%）死亡。在分析肠切除术后患者的死亡率时，高急性生理学和慢性健康评估（APACHE）II 评分（p<0.01）和更长的肠切除长度（p=0.047）在单变量分析中与死亡率显著相关。明确肠切除术后存活患者的并发症发生率为 66.7%。
结论
肠切除术是治疗肠系膜缺血性 HPVG 患者的唯一潜在救生疗法。高 APACHE II 评分和潜在坏死肠的严重程度决定了肠切除术后患者的结果。
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