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胃修复术后的对比研究:成人 1 级创伤中心的发病率、结果和危险因素的回顾。

Contrast study after gastric repair: a review of incidence, outcomes and risk factors at an adult level 1 trauma center.

机构信息

Department of Surgery, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA, 30310, USA.

Department of Health and Preventive Medicine, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA, 30310, USA.

出版信息

Eur J Trauma Emerg Surg. 2022 Oct;48(5):4143-4147. doi: 10.1007/s00068-022-01949-4. Epub 2022 Apr 2.

Abstract

PURPOSE

The role of contrast study after traumatic gastric repair, continues to be controversial. To that end, we aim to review the incidence, outcomes, and risk factors of patients undergoing contrast study after traumatic gastric repair.

METHODS

This was a retrospective review of all trauma patients admitted to a level 1 trauma center that sustained gastric injuries with subsequent repair between 2011 and 2018. Demographics, surgical interventions, complications, and clinical outcomes were evaluated. Statistical analysis included Chi-square/Fisher exact univariate analysis and multivariate logistic regression analysis with a 5% significance level.

RESULTS

A total of 233 patients received a gastric repair, of whom 49 (21%) had a contrast study performed. Out of 49 patients with a contrast study, one was found to have a gastric leak. Mean time to contrast study was 6.3 ± 2.7 days. There was no statistically significant difference in post-operative complications between non-contrast and contrast study groups. Multivariate logistic regression analysis demonstrated a lack of statistical significance in clinical risk factors that would lead to obtaining a contrast study.

CONCLUSION

Gastric leak after repair is rare and there is no statistically significant difference in clinical outcomes when comparing patients who underwent contrast study to those who did not. Routine contrast study after traumatic gastric repair may not be necessary and further evidence is warranted to determine the risk factors for a selective contrast study.

摘要

目的

创伤性胃修复后进行对比研究的作用仍存在争议。为此,我们旨在回顾创伤性胃修复后进行对比研究的患者的发生率、结局和危险因素。

方法

这是对 2011 年至 2018 年期间在一家一级创伤中心接受胃损伤修复的所有创伤患者进行的回顾性研究。评估了人口统计学、手术干预、并发症和临床结局。统计分析包括卡方/ Fisher 确切性单变量分析和多变量逻辑回归分析,显著性水平为 5%。

结果

共有 233 例患者接受了胃修复,其中 49 例(21%)进行了对比研究。在 49 例进行对比研究的患者中,有 1 例发现胃漏。行对比研究的平均时间为 6.3±2.7 天。非对比研究组和对比研究组的术后并发症无统计学差异。多变量逻辑回归分析表明,没有统计学意义的临床危险因素会导致进行对比研究。

结论

胃修复后发生漏的情况很少,且进行对比研究与未进行对比研究的患者在临床结局方面无统计学差异。创伤性胃修复后常规进行对比研究可能没有必要,需要进一步的证据来确定选择性对比研究的危险因素。

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