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62 例溃疡性结肠炎患者的手术治疗结局:一项来自波兰的回顾性单中心研究。

Surgical Outcomes in 62 Patients with Ulcerative Colitis: A Retrospective, Single-Center Study from Poland.

机构信息

Students' Scientific Society, Department of Digestive Tract Surgery, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Katowice, Poland.

Department of Digestive Tract Surgery, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Katowice, Poland.

出版信息

Med Sci Monit. 2023 May 10;29:e939412. doi: 10.12659/MSM.939412.

Abstract

BACKGROUND Surgery continues to play an important role in the treatment of ulcerative colitis (UC), which is one of the most common inflammatory diseases of the colon and rectum. This retrospective study from a single center in Poland aimed to evaluate surgical outcomes in 62 patients with ulcerative colitis. MATERIAL AND METHODS The study enrolled 62 patients (36 men [58.1%], 26 women [41.9%]), mean age 52.69±16.84 (range, 19-96) years who underwent surgical treatment of UC during the period 2001-2020. The mandatory inclusion criteria were patients with UC, who underwent total intra-abdominal colectomy (n=22, 46.8%), proctocolectomy (n=25, 53.2%), or left-sided hemicolectomy (n=8, 12.9%). The primary endpoint was postoperative death, and secondary endpoints were long hospitalization (>15 days), complications, and relaparotomy. RESULTS Postoperative mortality was observed in 8 (12.9%) patients. Older age and low albumin level were associated with longer hospitalization time (P=0.004 and P<0.001, respectively). High C-reactive protein (CRP) level (P=0.003), high CRP/albumin ratio (P=0.023), and malnourishment (P=0.026) were risk factors for complications. Malnutrition (P=0.026), older age (P=0.031), high CRP level (p<0.001), high CRP/albumin ratio (P=0.014), arterial hypertension (P=0.012), and urgent surgeries (P=0.021) were associated with higher risk of postoperative death. Patients who had undergone previous surgeries were more likely to need relaparotomy (P=0.022). CONCLUSIONS Preoperative nutritional status was an important factor associated with postoperative outcomes in patients with ulcerative colitis. Correction of malnutrition seems to be a vital part of preoperative preparation.

摘要

背景

手术在溃疡性结肠炎(UC)的治疗中继续发挥重要作用,UC 是结肠和直肠最常见的炎症性疾病之一。这项来自波兰单一中心的回顾性研究旨在评估 62 例溃疡性结肠炎患者的手术结果。

材料与方法

该研究纳入了 62 例(36 名男性[58.1%],26 名女性[41.9%]),平均年龄 52.69±16.84 岁(19-96 岁)的患者,这些患者在 2001-2020 年期间接受了 UC 的全腹腔结肠切除术(n=22,46.8%)、直肠结肠切除术(n=25,53.2%)或左侧结肠切除术(n=8,12.9%)。主要终点是术后死亡,次要终点是住院时间延长(>15 天)、并发症和再次剖腹手术。

结果

8 例(12.9%)患者出现术后死亡。高龄和低白蛋白水平与住院时间延长相关(P=0.004 和 P<0.001)。高 C 反应蛋白(CRP)水平(P=0.003)、高 CRP/白蛋白比值(P=0.023)和营养不良(P=0.026)是并发症的危险因素。营养不良(P=0.026)、高龄(P=0.031)、高 CRP 水平(P<0.001)、高 CRP/白蛋白比值(P=0.014)、动脉高血压(P=0.012)和急诊手术(P=0.021)与术后死亡风险增加相关。曾接受过手术的患者更有可能需要再次剖腹手术(P=0.022)。

结论

术前营养状况是溃疡性结肠炎患者术后结局的一个重要因素。纠正营养不良似乎是术前准备的重要组成部分。

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