2017年埃塞俄比亚内克梅特转诊医院小肠梗阻的病因及治疗结果

Causes and Management Outcome of Small Intestinal Obstruction in Nekemte Referral Hospital, Nekemte, Ethiopia, 2017.

作者信息

Jemere Tadeg, Getahun Berhanu, Tesfaye Mahlet, Muleta Geremew, Yimer Nega

机构信息

Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Integrated Emergency Gyn/Obs and General Surgery Professional, Amedwerk Hospital, Amdewerk, Ethiopia.

出版信息

Surg Res Pract. 2021 Nov 8;2021:9927779. doi: 10.1155/2021/9927779. eCollection 2021.

DOI:10.1155/2021/9927779

PMID:34790860

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8592772/

Abstract

BACKGROUND

Small bowel obstruction is a common and dangerous surgical emergency which is associated with high morbidity and mortality if not managed appropriately and timely.

OBJECTIVE

To determine the causes and management outcome of small bowel obstruction in Nekemte Referral Hospital, Nekemte, Ethiopia.

METHOD

Institution-based retrospective cross-sectional study design was used. Three-year data (from January 1, 2014, to December 30, 2016) were collected from July 1 to August 30, 2017. Data were collected from medical records and checked for any inconsistency, coded, and entered into SPSS version 20 for analysis. Descriptive, binary, and multivariate logistic regression analyses were used. On binary logistic regression analysis, variables with ≤ 0.25 were selected as a candidate for multivariate logistic regression analysis. The level of statistical significance was set at ≤ 0.05.

RESULTS

With 100% response rate, records of 211 patients with small intestinal obstruction were retrieved for analysis. One hundred thirty-seven (64.9%) were males. The commonest cause of small bowel obstruction was adhesion (35.1%). More than a quarter (26.5%) participants developed postoperative complications, and wound infection was the commonest postoperative complication (49.2%). A majority (84.8%) of patients improved and were discharged, and the rest 15.2% of patients died. Sex (AOR = 3.98, 95% CI: 1.51-10.52), duration of illness before surgical intervention (AOR = 4.4, 95% CI: 1.69-11.45), level of hematocrit (AOR = 4.25, 95% CI: 1.56-11.57), types of intestinal obstruction (AOR = 3.73, 95% CI: 1.09-12.64), and length of hospital stay (AOR = 4.69, 95% CI: 1.82-12.07) were independent predictors of the management outcome of patients with small bowl obstruction.

CONCLUSION

Small bowel obstruction is a commonly encountered surgical emergency. Adhesion, small bowel volvulus, and intussusception were the leading causes of small bowel obstruction, respectively.

摘要

背景

小肠梗阻是一种常见且危险的外科急症，如果处理不当或不及时，会导致高发病率和死亡率。

目的

确定埃塞俄比亚内克梅特转诊医院小肠梗阻的病因及治疗结果。

方法

采用基于机构的回顾性横断面研究设计。收集了三年的数据（从2014年1月1日至2016年12月30日），收集时间为2017年7月1日至8月30日。从病历中收集数据，检查是否存在任何不一致之处，进行编码，并录入SPSS 20版本进行分析。采用描述性、二元和多变量逻辑回归分析。在二元逻辑回归分析中，将P≤0.25的变量选为多变量逻辑回归分析的候选变量。设定统计学显著性水平为P≤0.05。

结果

应答率为100%，检索到211例小肠梗阻患者的记录进行分析。137例（64.9%）为男性。小肠梗阻最常见的原因是粘连（35.1%）。超过四分之一（26.5%）的参与者出现术后并发症，伤口感染是最常见的术后并发症（49.2%）。大多数（84.8%）患者病情好转并出院，其余15.2%的患者死亡。性别（比值比[AOR]=3.98，95%置信区间[CI]：1.51-10.52）、手术干预前的病程（AOR=4.4，95%CI：1.69-11.45）、血细胞比容水平（AOR=4.25，95%CI：1.56-11.57）、肠梗阻类型（AOR=3.73，95%CI：1.09-12.64）和住院时间（AOR=4.69，95%CI：1.82-12.07）是小肠梗阻患者治疗结果的独立预测因素。