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基于血尿素氮和白细胞计数的门静脉系统血栓形成患者肠坏死预测模型:一项回顾性研究

Prediction model based on blood urea nitrogen and the leukocyte count for intestinal necrosis in patients with portal vein system thrombosis: a retrospective study.

作者信息

Wei Qiang, He Zenglei, Wang Kun, Li Changbiao, Al Ameri Abdulahad, Zheng Shusen, Xu Xiao

机构信息

Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

Ann Transl Med. 2020 Mar;8(6):326. doi: 10.21037/atm.2020.02.108.

Abstract

BACKGROUND

Portal vein system thrombosis (PVST) is a serious and potentially fatal disease. No definite parameter can predict intestinal necrosis in patients with PVST to justify early surgical intervention. The current study aimed to explore a simple and accurate model to predict the occurrence of intestinal necrosis in patients with PVST.

METHODS

Records of patients admitted to our emergency department with PVST from January 2010 to October 2018 were reviewed. Clinical parameters, including patient history, physical examination, and the results of laboratory investigations, were analyzed.

RESULTS

Sixty-nine patients (27 females) were included. All patients were admitted to our emergency department because of abdominal pain. Fourteen patients required exploratory laparotomy, and intestinal necrosis was confirmed. Seven patients received thrombolytic therapy, and the other 48 patients had completed anticoagulation successfully. According to multivariate logistic regression, high blood urea nitrogen (BUN) (OR: 1.413, P=0.048) and the leukocyte count (OR: 1.180, P=0.005) were associated with intestinal necrosis, and a prediction model for intestinal necrosis (PMIN) based on the BUN and leukocyte count was established.

CONCLUSIONS

The PMIN score could effectively predict intestinal necrosis in patients with PVST.

摘要

背景

门静脉系统血栓形成(PVST)是一种严重且可能致命的疾病。尚无明确参数可预测PVST患者的肠坏死情况以证明早期手术干预的合理性。本研究旨在探索一种简单且准确的模型来预测PVST患者肠坏死的发生。

方法

回顾了2010年1月至2018年10月在我院急诊科收治的PVST患者的记录。分析了临床参数,包括患者病史、体格检查和实验室检查结果。

结果

纳入69例患者(27例女性)。所有患者均因腹痛入住我院急诊科。14例患者需要进行剖腹探查,确诊为肠坏死。7例患者接受了溶栓治疗,其他48例患者成功完成了抗凝治疗。根据多因素逻辑回归分析,高血尿素氮(BUN)(比值比:1.413,P = 0.048)和白细胞计数(比值比:1.180,P = 0.005)与肠坏死相关,并建立了基于BUN和白细胞计数的肠坏死预测模型(PMIN)。

结论

PMIN评分可有效预测PVST患者的肠坏死情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bd6/7186628/2e787b058a5e/atm-08-06-326-f1.jpg

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