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本文引用的文献

1
Damage control surgery.损伤控制外科手术
Curr Opin Crit Care. 2015 Dec;21(6):538-43. doi: 10.1097/MCC.0000000000000252.
2
Evaluating the use of fibrin glue for sealing low-output enterocutaneous fistulas: study protocol for a randomized controlled trial.评估纤维蛋白胶用于封闭低流量肠皮肤瘘的效果:一项随机对照试验的研究方案
Trials. 2015 Oct 7;16:445. doi: 10.1186/s13063-015-0966-9.
3
Sepsis-Induced Acute Kidney Injury.脓毒症诱导的急性肾损伤
Crit Care Clin. 2015 Oct;31(4):649-60. doi: 10.1016/j.ccc.2015.06.003. Epub 2015 Jul 29.
4
Risk Factors and Outcome for Massive Intra-Abdominal Bleeding Among Patients With Infected Necrotizing Pancreatitis.感染性坏死性胰腺炎患者腹腔内大出血的危险因素及预后
Medicine (Baltimore). 2015 Jul;94(28):e1172. doi: 10.1097/MD.0000000000001172.
5
Administration of fibrinogen concentrate for refractory bleeding in massively transfused, non-trauma patients with coagulopathy: a retrospective study with comparator group.在大量输血且患有凝血病的非创伤性患者中,使用纤维蛋白原浓缩物治疗难治性出血:一项设有对照的回顾性研究
BMC Anesthesiol. 2014 Nov 26;14:109. doi: 10.1186/1471-2253-14-109. eCollection 2014.
6
Update on massive transfusion.大量输血更新。
Br J Anaesth. 2013 Dec;111 Suppl 1:i71-82. doi: 10.1093/bja/aet376.
7
Cholecysto-duodenal fistula as the source of upper gastrointestinal bleeding.胆囊十二指肠瘘作为上消化道出血的来源。
Endoscopy. 2013;45 Suppl 2 UCTN:E250-1. doi: 10.1055/s-0033-1344418. Epub 2013 Sep 5.
8
Enterocutaneous fistula in University of Port Harcourt Teaching Hospital.哈科特港大学教学医院的肠皮肤瘘
Niger J Med. 2013 Apr-Jun;22(2):93-6.
9
Secondary aorto-enteric fistula presenting over a 2-month period with recurrent gastrointestinal bleeding.继发性主动脉肠瘘在2个月内出现反复胃肠道出血。
BMJ Case Rep. 2013 Apr 15;2013:bcr2012008070. doi: 10.1136/bcr-2012-008070.
10
Enterocutaneous fistula: a review of 82 cases.肠皮肤瘘:82例病例回顾
Niger J Clin Pract. 2013 Apr-Jun;16(2):174-7. doi: 10.4103/1119-3077.110140.

肠皮肤瘘患者腹腔内出血的危险因素及预后

Risk factor and outcome for intra-abdominal bleeding in patients with enterocutaneous fistula.

作者信息

Wu Lei, Ren Jianan, Liu Qinjie, Wang Gefei, Wu Xiuwen, Gu Guosheng, Li Guanwei, Guo Kun, Hong Zhiwu, Hu Qiongyuan, Ren Huajian, Li Jieshou

机构信息

Department of General Surgery, Jinling Hospital, Medical School of Nanjing University Department of General Surgery, Jinling Hospital, Nanjing Medical University Medical School of Southeast University, Nanjing, China.

出版信息

Medicine (Baltimore). 2016 Nov;95(47):e5369. doi: 10.1097/MD.0000000000005369.

DOI:10.1097/MD.0000000000005369
PMID:27893673
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5134866/
Abstract

Intra-abdominal bleeding is a major and lethal complication in patients with enterocutaneous fistula (ECF) while few studies are involved in this aspect. In the present study, we aimed to investigate the risk factors and assessed the outcome for intra-abdominal bleeding in patients with ECF.A retrospective study was performed from October 2013 to October 2015. Medical records of 67 ECF patients with intra-abdominal bleeding and 134 ECF patients without intra-abdominal bleeding matched as controls were reviewed and analyzed. Logistic regression was performed to evaluate the risk factor of intra-abdominal bleeding in patients with ECF. Outcomes such as mortality, hospital durations, and cost were compared between ECF patients with or without intra-abdominal bleeding.A total of 67 ECF patients suffered intra-abdominal bleeding during hospitalization. In the logistic regression, duodenum fistula (odds ratio [OR]: 3.899, 95% confidence interval [CI]: 1.204-12.634, P = 0.023), hemorrhage history (OR: 15.846 95% CI: 5.779-43.448, P < 0.001), and acute kidney injury (OR: 6.350 95% CI: 2.033-19.836, P = 0.001) were independent risk factors for intra-abdominal bleeding in patients with ECF. In addition, the bleeding patients showed a significantly higher mortality rate, prolonged total parenteral nutrition days, hospital and intensive care unit durations, more complications, and increased cost.We revealed the 3 risk factors for intra-abdominal bleeding among ECF patients. Besides, intra-abdominal hemorrhage was associated with a poor prognosis in patients with ECF.

摘要

腹腔内出血是肠外瘘(ECF)患者的一种主要且致命的并发症,然而这方面的研究较少。在本研究中,我们旨在调查ECF患者腹腔内出血的危险因素并评估其结局。

我们进行了一项回顾性研究,时间跨度为2013年10月至2015年10月。回顾并分析了67例发生腹腔内出血的ECF患者以及134例未发生腹腔内出血的ECF患者作为对照的病历。采用逻辑回归分析评估ECF患者腹腔内出血的危险因素。比较了发生或未发生腹腔内出血的ECF患者的死亡率、住院时间和费用等结局。

共有67例ECF患者在住院期间发生腹腔内出血。在逻辑回归分析中,十二指肠瘘(比值比[OR]:3.899,95%置信区间[CI]:1.204 - 12.634,P = 0.023)、出血史(OR:15.846,95%CI:5.779 - 43.448,P < 0.001)和急性肾损伤(OR:6.350,95%CI:2.033 - 19.836,P = 0.001)是ECF患者腹腔内出血的独立危险因素。此外,出血患者的死亡率显著更高,全胃肠外营养天数、住院和重症监护病房时间延长,并发症更多,费用增加。

我们揭示了ECF患者腹腔内出血的3个危险因素。此外,腹腔内出血与ECF患者的不良预后相关。