Helvaci Mehmet Rami, Aydogan Akin, Akkucuk Seckin, Oruc Cem, Ugur Mustafa
Medical Faculty of The Mustafa Kemal University Turkey.
Int J Clin Exp Med. 2014 Sep 15;7(9):2871-6. eCollection 2014.
We tried to understand whether or not there is an increased incidence of ileus in patients with sickle cell diseases (SCDs).
All cases with SCDs were taken into the study.
The study included 325 patients (160 females). The mean ages were similar in both sexes (29.3 versus 29.8 years in females and males, respectively, p > 0.05). Incidence of ileus was higher in males, significantly (3.6% versus 1.2%, p < 0.01). All of the ileus cases were able to be treated with simple and repeated red blood cell (RBC) transfusions without any surgical procedure. Smoking was higher in males, too (21.8% versus 6.2%, p < 0.001). The mean hematocrit value was also higher in males, significantly (24.4% versus 23.0%, p = 0.016). RBC units transfused, digital clubbing, leg ulcers, pulmonary hypertension, chronic obstructive pulmonary disease, coronary heart disease, and chronic renal disease were all higher in males, too (p < 0.05 for all). On the other hand, although the general mortality, white blood cell and platelet counts of peripheric blood, painful crises per year, rheumatic heart disease, avascular necrosis of bone, cirrhosis, and stroke were all higher in males, the differences were nonsignificant probably due to the small sample sizes of the groups (p > 0.05 for all).
Although the relatively young mean ages of the patients with SCDs, the very high incidences of ileus are probably due to the strong atherosclerotic and obstructive natures of the two pathologies, and ileus should be treated with simple and repeated RBC transfusions to restore bowel perfusion in such patients.
我们试图了解镰状细胞病(SCD)患者肠梗阻的发病率是否增加。
所有SCD病例均纳入研究。
该研究纳入了325例患者(160例女性)。男女平均年龄相似(女性为29.3岁,男性为29.8岁,p>0.05)。男性肠梗阻的发病率更高,差异有统计学意义(3.6%对1.2%,p<0.01)。所有肠梗阻病例均能通过简单且反复的红细胞(RBC)输血进行治疗,无需任何外科手术。男性吸烟率也更高(21.8%对6.2%,p<0.001)。男性的平均血细胞比容值也显著更高(24.4%对23.0%,p=0.016)。男性输注的RBC单位数、杵状指、腿部溃疡、肺动脉高压、慢性阻塞性肺疾病、冠心病和慢性肾病也都更高(所有p<0.05)。另一方面,尽管男性的总体死亡率、外周血白细胞和血小板计数、每年的疼痛性危象、风湿性心脏病、骨缺血性坏死、肝硬化和中风均更高,但由于各组样本量较小,差异可能无统计学意义(所有p>0.05)。
尽管SCD患者的平均年龄相对较轻,但肠梗阻的高发病率可能归因于这两种疾病强烈的动脉粥样硬化和阻塞性本质,对于此类患者,应通过简单且反复的RBC输血来治疗肠梗阻,以恢复肠道灌注。