Department of General Surgery, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
World J Emerg Surg. 2013 Nov 25;8(1):49. doi: 10.1186/1749-7922-8-49.
We investigated prognostic parameters of patients who underwent surgical intervention for acute mesenteric ischemia by evaluating demographic characteristics and laboratory data on admission.
The hospital records of 30 patients who underwent surgical interventions due to acute mesenteric ischemia between January 2008 and December 2012, were reviewed retrospectively. The records were investigated with regard to demographic data, the presence of co-morbid diseases, presenting complaints, time elapsed between symptom onset and hospital admission, laboratory findings at admission, findings at surgical exploration, surgical methods used, and treatment outcomes. The patients were divided into two groups, according to death (Group 1) or survival (Group 2), and the two groups were compared in terms of the specified parameters.
Of the patients, 15 were male (50%) and 15 female (50%); their mean age was 71.4 (29-94) years. Abdominal pain was the chief complaint in all patients (100%) and mean time from pain onset to hospital admission was 21 (1-72) h. In abdominal exploration, total small bowel (SB) ischemia and necrosis was found in 6 (20%) patients and other patients had subtotal SB, segmental SB, segmental SB with colon, or isolated colon ischemia. Treatment in 15 patients (50%) ended in mortality. Mean age (p = 0.038), urea (p = 0.002), AST (p < 0.001), ALT (p < 0.001), mean platelet volume (MPV; p = 0.002), and amylase (p = 0.022) levels in Group 1 were significantly higher versus Group 2, whereas Ca (p = 0.024) and albumin (p = 0.002) levels were significantly lower.
In this study, unlike other parameters that have been shown to be of prognostic significance in mesenteric ischemia, MPV values at presentation were higher among non-survivors than survivors.
我们通过评估入院时的人口统计学特征和实验室数据,研究了因急性肠系膜缺血而行手术干预的患者的预后参数。
回顾性分析了 2008 年 1 月至 2012 年 12 月期间因急性肠系膜缺血而行手术干预的 30 例患者的住院病历。调查了患者的人口统计学数据、合并症、主诉、症状发作至入院的时间、入院时的实验室检查结果、手术探查结果、使用的手术方法和治疗结果。根据死亡(第 1 组)或存活(第 2 组),将患者分为两组,并对两组患者进行了比较。
患者中男 15 例(50%),女 15 例(50%),平均年龄 71.4(29-94)岁。所有患者均有腹痛主诉(100%),从疼痛发作到入院的平均时间为 21(1-72)h。在腹部探查中,6 例(20%)患者全小肠(SB)缺血坏死,其他患者为 SB 次全、节段 SB、SB 合并结肠或孤立性结肠缺血。15 例(50%)患者的治疗以死亡告终。第 1 组的平均年龄(p=0.038)、尿素(p=0.002)、AST(p<0.001)、ALT(p<0.001)、平均血小板体积(MPV;p=0.002)和淀粉酶(p=0.022)水平明显高于第 2 组,而第 1 组的 Ca(p=0.024)和白蛋白(p=0.002)水平明显低于第 2 组。
与其他已被证明对肠系膜缺血有预后意义的参数不同,本研究中,非幸存者的入院时 MPV 值高于幸存者。