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经皮或手术治疗的包虫病患者死亡率增加的因素。对 1143 例患者的回顾性单中心研究。

Factors increasing mortality in Echinococcosis patients treated percutaneously or surgically. A review of 1,143 patients: a retrospective single center study.

机构信息

Department of Anesthesiology and Reanimation, Medicine Faculty, University of Harran, Sanliurfa, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2023 Jan;27(2):493-500. doi: 10.26355/eurrev_202301_31049.

Abstract

OBJECTIVE

While cystic echinococcosis (CE) is a serious problem in underdeveloped countries, it also becomes a serious public health problem in developed countries due to recent migration and population movements. This study aimed to investigate the relationship between pregnancy, multi-organ involvement, treatment methods, and emergency surgery (unfollowed patients), with mortality in patients with CE who underwent surgical or percutaneous treatment.

PATIENTS AND METHODS

In this study, demographic characteristics, pregnancy status, organ involvement, development of relapse and anaphylaxis, need for intensive care and mortality rates of patients with CE treated with percutaneous or surgical methods at Harran University Hospital between January 1997 to January 2022 were investigated.

RESULTS

Of the 1,143 patients who underwent surgery or percutaneous treatment for CE, 18 were pregnant. Mortality was found to be significantly higher in pregnant patients with CE (p<0.001). Mortality was significantly higher in those who developed anaphylaxis (p<0.001). In percutaneous treatment, recurrence (p<0.001) and anaphylaxis (p=0.026) were found to be significantly higher. Mortality was found to be three times higher in patients without follow-up who were operated on urgently (p=0.108).

CONCLUSIONS

CE is a disease that can occur at any age and can be fatal. Although multi-organ involvement and percutaneous treatment may be associated with recurrence, they do not directly increase mortality. The mortality is high, especially in pregnant women with pulmonary CE. Cardiac involvement, brain involvement and anaphylaxis increase mortality. Mortality is higher in patients without follow-up who are operated on urgently.

摘要

目的

虽然囊性包虫病(CE)在欠发达国家是一个严重的问题,但由于最近的移民和人口流动,它在发达国家也成为一个严重的公共卫生问题。本研究旨在探讨妊娠、多器官受累、治疗方法和急诊手术(未随访患者)与接受手术或经皮治疗的 CE 患者死亡率之间的关系。

患者和方法

本研究调查了 1997 年 1 月至 2022 年 1 月在哈兰大学医院接受经皮或手术方法治疗的 CE 患者的人口统计学特征、妊娠状态、器官受累、复发和过敏反应的发展、需要重症监护和死亡率。

结果

在接受手术或经皮治疗的 1143 例 CE 患者中,有 18 例妊娠。CE 妊娠患者的死亡率明显更高(p<0.001)。发生过敏反应的患者死亡率明显更高(p<0.001)。在经皮治疗中,复发(p<0.001)和过敏反应(p=0.026)明显更高。未随访的紧急手术患者死亡率高 3 倍(p=0.108)。

结论

CE 是一种可发生于任何年龄的疾病,可导致死亡。尽管多器官受累和经皮治疗可能与复发有关,但它们不会直接增加死亡率。死亡率较高,尤其是肺 CE 合并妊娠的患者。心脏受累、脑受累和过敏反应会增加死亡率。未随访的紧急手术患者死亡率更高。

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