Yoo Taeyoung, Yang Keun Ho, Kim Jungbin, Park Inseok, Cho Hyunjin, Gwak Geumhee, Bae Byung Noe, Kim Ki Hwan
Department of Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Ann Coloproctol. 2018 Feb;34(1):23-28. doi: 10.3393/ac.2018.34.1.23. Epub 2018 Feb 28.
The aim of this study is to determine the predictable factors that affect the clinical course, especially the hospital stay, the operation performed, and to determine factors that will be helpful in deciding whether in-hospital or outpatient treatment is appropriate.
We retrospectively collected medical data for patients who had been diagnosed with acute diverticulitis at Inje University Sanggye Paik Hospital between January and December 2016. In total, 117 patients were enrolled in this study. We examined clinical factors, including age, sex, body mass index, pain, body temperature, white blood cell count, C-reactive protein, nil per os (NPO) time, hospital duration, computed tomography (CT) findings, location of diverticulitis, operation performed, and presence of comorbidity (e.g., hypertension and diabetes mellitus).
In the multivariate analysis, the statistically significant factor related with hospital duration was the presence of perforation on the CT scan (P < 0.001). Longer NPO time was related with pain score (>7) (P = 0.011). Operations were mainly performed in patients with left-sided colonic diverticulitis (P = 0.012).
We suggest a perforation finding on the CT scan, a severe pain score at least above 7 on a numeric rating pain scale, and a left-sided lesion are absolute indications for in-hospital management.
本研究旨在确定影响临床病程的可预测因素，尤其是住院时间、所进行的手术，并确定有助于决定住院治疗还是门诊治疗是否合适的因素。
我们回顾性收集了2016年1月至12月在仁济大学 sanggye 白医院被诊断为急性憩室炎的患者的医疗数据。本研究共纳入117例患者。我们检查了临床因素，包括年龄、性别、体重指数、疼痛、体温、白细胞计数、C反应蛋白、禁食时间、住院时间、计算机断层扫描（CT）结果、憩室炎的位置、所进行的手术以及合并症（如高血压和糖尿病）的存在情况。
在多变量分析中，与住院时间相关的具有统计学意义的因素是CT扫描显示存在穿孔（P < 0.001）。较长的禁食时间与疼痛评分（>7）相关（P = 0.011）。手术主要在左侧结肠憩室炎患者中进行（P = 0.012）。
我们建议CT扫描发现穿孔、数字评分疼痛量表上疼痛评分至少高于7分以及左侧病变是住院治疗的绝对指征。
