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肠系膜静脉血栓形成患者肠坏死的预测性风险因素:单中心回顾性研究。

Predictive Risk Factors of Intestinal Necrosis in Patients with Mesenteric Venous Thrombosis: Retrospective Study from a Single Center.

机构信息

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Can J Gastroenterol Hepatol. 2019 May 7;2019:8906803. doi: 10.1155/2019/8906803. eCollection 2019.

Abstract

PURPOSES

Mesenteric venous thrombosis (MVT) is a serious condition. The current study aimed to identify risk factors of intestinal necrosis (IN) in patients with MVT to predict the onset of patients.

METHODS

Data pertaining to patients diagnosed with MVT between 2014 and May 2018 were reviewed. Patients' characteristics and risk factors of IN were assessed.

RESULTS

Seventy-eight patients were included in our study, of whom all cases were diagnosed as superior mesenteric venous thrombosis. There were fifty-eight cases (74%) with intestinal necrosis and twenty cases (26%) without intestinal necrosis. Multivariate analysis of factors associated with IN was organ failure (odds ratio (OR): 4.1; 95% confidence interval (95%CI): 1.26-8.59; =0.028), elevated serum lactate (OR:3.6; 95% CI: 1.51-5.47; =0.024), bowel loop dilation on computerized tomography (CT) scan (OR: 2.8; 95% CI: 1.32-7.23; =0.031), and the time between onset of symptoms and operation (OR: 4.8; 95% CI: 1.36-9.89; =0.012). Area under the receiver operating characteristics curve for the diagnosis of IN with MVT was 0.901 (95%CI: 0.809-0.993; P=0.000) depending on the different number of predictive factors.

CONCLUSION

Predictive risk factors for IN with MVT were organ failure, elevated serum lactate level, bowel loop dilation on CT, and the time between onset of symptoms and operation. However, this result is from a retrospective study and further long-term, large-sample prospective studies are required to confirm this finding.

摘要

目的

肠系膜静脉血栓形成(MVT)是一种严重的疾病。本研究旨在确定 MVT 患者发生肠坏死(IN)的危险因素,以预测患者的发病情况。

方法

回顾性分析 2014 年至 2018 年 5 月期间诊断为 MVT 的患者资料,评估患者的特征和 IN 的危险因素。

结果

本研究共纳入 78 例患者,均为肠系膜上静脉血栓形成。其中肠坏死 58 例(74%),无肠坏死 20 例(26%)。多因素分析与 IN 相关的因素包括器官衰竭(比值比(OR):4.1;95%置信区间(95%CI):1.26-8.59;=0.028)、血清乳酸升高(OR:3.6;95%CI:1.51-5.47;=0.024)、计算机断层扫描(CT)显示肠袢扩张(OR:2.8;95%CI:1.32-7.23;=0.031)以及症状发作与手术时间(OR:4.8;95%CI:1.36-9.89;=0.012)。基于不同数量的预测因素,MVT 合并 IN 的诊断受试者工作特征曲线下面积为 0.901(95%CI:0.809-0.993;P=0.000)。

结论

MVT 合并 IN 的预测危险因素包括器官衰竭、血清乳酸水平升高、CT 显示肠袢扩张以及症状发作与手术时间。然而,这一结果来自于回顾性研究,需要进一步进行长期、大样本的前瞻性研究来证实这一发现。

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