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宁夏地区肠梗阻的病因谱:10年期间4908例病例的回顾性分析

Etiologic Spectrum of Intestinal Obstruction in Ningxia District: A Retrospective Analysis of 4908 Cases in a 10-Year Period.

作者信息

Jiang Wei, Li Wenyan, Hao Qian, Yao Yuping, Li Yajun, Ge Jun, Zhai Huihong

机构信息

Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing 100050, China.

出版信息

Gastroenterol Res Pract. 2019 Jun 26;2019:4935947. doi: 10.1155/2019/4935947. eCollection 2019.

Abstract

BACKGROUND

Economic disparity contributes to the variation of intestinal obstruction (IO) etiologic spectrum. Clarifying the etiology distribution in local regions can help to unravel IO and promote early diagnosis, henceforth making sure standardized therapeutic interventions.

METHODS

Medical data of 4908 inpatients diagnosed with IO admitted to the General Hospital of Ningxia Medical University between January 2004 and December 2013 were recruited and analyzed retrospectively. The associated profiles included demographic features, clinical manifestations, and previous therapeutic operations.

RESULTS

4908 cases of intestinal obstruction were identified during the period of study. It denoted that the hospitalization rate of IO has maintained upward momentum; the top four causes of IO were adhesion, tumor, intussusception, and hernias. These covered up nearly 80% of the total constitution. Among them, adhesive intestinal obstruction accounted for 45.17%, malignant bowel obstruction for 21.09%, intussusception for 8.72%, and hernia for 4.73%; abdominal surgery constituted for the majority (78.62%) of adhesive obstruction. The followed up analysis also found that appendectomy accounted for the biggest percentage, 28% of operation cases. Malignant bowel obstruction can have a rate of 96.43% in 1035 cases led by tumor lesions. Of which, the primary intestinal malignant tumor accounted for 68.64% and metastatic tumors for 31.36%. Nearly 50% occurred in the large intestine. The overall mortality of all 4908 cases was 4.7%.

CONCLUSION

The hospitalizations of IO delineated an increasing trend. Adhesion was the main etiology in IO. The odds of malignant bowel obstruction was increasing in the proportion of IO. There were some differences towards the etiologic spectrum compared with western countries.

摘要

背景

经济差异导致肠梗阻(IO)病因谱存在差异。明确当地病因分布有助于了解肠梗阻并促进早期诊断,从而确保标准化治疗干预措施。

方法

回顾性分析2004年1月至2013年12月在宁夏医科大学总医院收治的4908例诊断为肠梗阻的住院患者的医疗数据。相关资料包括人口统计学特征、临床表现和既往治疗手术情况。

结果

研究期间共确诊4908例肠梗阻病例。这表明肠梗阻的住院率呈上升趋势;肠梗阻的前四大病因是粘连、肿瘤、肠套叠和疝。这些病因占总病例数的近80%。其中,粘连性肠梗阻占45.17%,恶性肠梗阻占21.09%,肠套叠占8.72%,疝占4.73%;腹部手术是粘连性肠梗阻的主要原因(78.62%)。进一步分析还发现,阑尾切除术占手术病例的比例最大,为28%。1035例由肿瘤病变导致的恶性肠梗阻发生率为96.43%。其中,原发性肠道恶性肿瘤占68.64%,转移性肿瘤占31.36%。近50%发生在大肠。4908例患者的总死亡率为4.7%。

结论

肠梗阻的住院率呈上升趋势。粘连是肠梗阻的主要病因。恶性肠梗阻在肠梗阻中的比例呈上升趋势。与西方国家相比,病因谱存在一些差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4255/6617931/6fee3c16900c/GRP2019-4935947.001.jpg

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