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非手术治疗阑尾炎性肿块患者时,重度梗阻对治疗结局的影响。

Impact of high-grade obstruction on outcomes in patients with appendiceal inflammatory masses managed by nonoperative treatment.

作者信息

Kim Mi Sung, Kim Hyuk Jung, Park Hae Won, Kwon Heon-Ju, Lee So-Yeon, Kook Shin Ho, Park Hee-Jin, Choi Yoon Jung

机构信息

Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Department of Radiology, Daejin Medical Center, Bundang Jesaeng General Hospital, Seongnam, Korea.

出版信息

Ann Surg Treat Res. 2017 Jun;92(6):429-435. doi: 10.4174/astr.2017.92.6.429. Epub 2017 May 29.

Abstract

PURPOSE

To retrospectively assess the impact of high-grade obstructions identified on initial CT on outcomes of patients with appendiceal inflammatory masses managed by nonoperative treatment.

METHODS

Institutional Review Boards approved this retrospective study and informed consent was waived. Included were 52 consecutive patients diagnosed with appendiceal inflammatory masses by CT scan and managed by nonoperative treatment. The main outcome measure was treatment failure and secondary outcomes were complications and initial and total hospital stay. Patient demographics, inflammatory markers, and CT findings for presence of an appendiceal inflammatory mass and high-grade obstruction were assessed. Patients with and without high-grade obstruction were compared for patient characteristics and outcomes using Fisher exact test and Student t-test.

RESULTS

Among 52 patients, 14 (27%) had high-grade obstruction on CT examination at presentation. No significant differences were observed in patient characteristics (P > 0.05), treatment failure (P = 0.33), complications (P = 0.29), or initial (P = 0.73) or total (P = 0.72) hospitalization between patients with and without high-grade obstruction.

CONCLUSION

For patients who were managed by nonoperative treatment for appendiceal inflammatory masses, the presence of high-grade obstruction identified on initial CT scan did not significantly affect outcomes of treatment failure, complications, and initial and total hospitalization.

摘要

目的

回顾性评估初次CT检查发现的高位梗阻对接受非手术治疗的阑尾炎性肿块患者预后的影响。

方法

机构审查委员会批准了这项回顾性研究,无需患者知情同意。纳入连续52例经CT扫描诊断为阑尾炎性肿块并接受非手术治疗的患者。主要结局指标为治疗失败,次要结局指标为并发症、初次住院时间和总住院时间。评估患者的人口统计学资料、炎症标志物以及阑尾炎性肿块和高位梗阻的CT表现。使用Fisher精确检验和Student t检验比较有和无高位梗阻患者的特征和结局。

结果

52例患者中,14例(27%)初次CT检查时存在高位梗阻。有和无高位梗阻患者在特征(P>0.05)、治疗失败(P = 0.33)、并发症(P = 0.29)、初次住院时间(P = 0.73)或总住院时间(P = 0.72)方面均未观察到显著差异。

结论

对于接受非手术治疗的阑尾炎性肿块患者,初次CT扫描发现的高位梗阻对治疗失败、并发症、初次住院时间和总住院时间的结局无显著影响。

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