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急性肠梗阻手术治疗后发生全身炎症反应综合征和脓毒症的危险因素。

Risk factors for the systemic inflammatory response syndrome and sepsis following surgical management of acute intestinal obstruction.

作者信息

Albabtain Ibrahim T, Almohanna Rema S, Alkhuraiji Arwa A, Alsalamah Raghad K, Almasoud Najla A, AlBaqmi Kholoud H, Althubaiti Alaa M

机构信息

Department of Surgery, King Abdulaziz Medical City, Riyadh, National Guard Health Affairs, Saudi Arabia.

College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

出版信息

Int J Health Sci (Qassim). 2021 Nov-Dec;15(6):28-33.

Abstract

OBJECTIVES

Infection is one of the major complications following intestinal obstruction surgery, yet predictors of its occurrence are not sufficiently reported. In this study, we examine the factors leading to postoperative inflammatory response syndrome (SIRS) and sepsis.

METHODS

The data of 213 patients who underwent intestinal obstruction surgery between 2015 to 2020 in King Abdulaziz Medical City, Riyadh, Saudi Arabia, were reviewed retrospectively. Patients' demographic characteristics and preoperative, intraoperative, and 30-day postoperative data were compared between patients who had postoperative SIRS/sepsis and patients who had no complications.

RESULTS

Ninety-six patients (44%) developed SIRS/sepsis within 30 days after surgery. More than half of the patients were males (55.8%), and the mean age at operation was 56.7(SD=20.0)years. Preoperative high heart rate, low albumin levels, and postoperative intensive care unit (ICU) admission were independently and significantly associated with developing SIRS/sepsis post-operation. The mortality rate in this study was estimated to be 7.5%; of those, 93.8% had SIRS/sepsis.

CONCLUSION

The 30-day mortality rate is considerably higher among patients who developed SIRS/sepsis after intestinal obstruction surgery. The independent risk factors of developing SIRS/sepsis after operation were elevated heart rate, low albumin levels preoperation, and ICU admission post-operation.

摘要

目的

感染是肠梗阻手术后的主要并发症之一,但其发生的预测因素报道不足。在本研究中,我们探究了导致术后炎症反应综合征(SIRS)和脓毒症的因素。

方法

回顾性分析2015年至2020年在沙特阿拉伯利雅得阿卜杜勒阿齐兹国王医疗城接受肠梗阻手术的213例患者的数据。比较发生术后SIRS/脓毒症的患者与无并发症患者的人口统计学特征以及术前、术中和术后30天的数据。

结果

96例患者(44%)在术后30天内发生SIRS/脓毒症。超过半数患者为男性(55.8%),平均手术年龄为56.7(标准差=20.0)岁。术前心率高、白蛋白水平低以及术后入住重症监护病房(ICU)与术后发生SIRS/脓毒症独立且显著相关。本研究中的死亡率估计为7.5%;其中,93.8%的患者发生了SIRS/脓毒症。

结论

肠梗阻手术后发生SIRS/脓毒症的患者30天死亡率相当高。术后发生SIRS/脓毒症的独立危险因素为心率升高、术前白蛋白水平低以及术后入住ICU。

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