成人急性粪石性小肠梗阻手术指征多因素分析  

Multiple factors influencing surgical indicaors of acute small bezoar intestinal obstruction in adults

作　　者：刘华锋 王振冉[1] LIU Huafeng;WANG Zhenran(Dept.of Gastrointestinal Surgery,the Affiliated Hospital of Guilin Medical University,Guilin 541001,China)

机构地区：[1]桂林医学院附属医院胃肠外科,广西桂林541001

出　　处：《华夏医学》2019年第5期91-94,共4页Acta Medicinae Sinica

摘　　要：目的:探讨成人急性粪石性小肠梗阻手术指征的相关影响因素。方法:回顾性分析本院收治的80例粪石性肠梗阻患者的临床资料,根据不同的治疗方式将选取的患者分为保守治疗组(n=46)和手术治疗组(n=34),收集患者的临床资料并通过单因素分析和多因素logistics线性回归分析影响手术治疗的相关因素。结果:通过单因素分析法比较两组患者的年龄、性别、粪石嵌顿位置、保守治疗时间、腹腔积液、持续腹痛、肠管是否扩张及白细胞计数等因素,除年龄、性别外,其余因素差异均有统计学意义(P<0.05),通过多因素logistics线性回归分析法比较可得出,粪石嵌顿位置、保守治疗时间、腹腔积液、持续腹痛、肠管是否扩张、白细胞计数升高均为判断患者是否需要手术治疗的重要参考因素(P<0.05)。结论:对于粪石性肠梗阻的患者,应通过多因素分析来判断患者病情并密切观察患者的病情变化,严格把握手术指征及手术时机,避免贻误病情及对可保守治疗患者造成不必要的手术打击。Objective:To investigate the related factors influencing the surgical indicators of acute small bezoar intestinal obstruction in adults.Methods:Clinical data of 80 patients with fecal stone ileus admitted to our hospital were analyzed retrospectively.According to different treatment methods,the selected patients were divided into the conservative treatment group(n=46)and surgical treatment group(n=34).The clinical data of the patients were collected and the relevant factors affecting the surgical treatment were analyzed by single factor analysis and multi-factor Logistic linear regression analysis.Results:Using single factor analysis to compare the differences of patients’age,sex,location of fecal stone impaction,time of conservative treatment,ascites,persistent abdominal pain,whether the intestine expanded or not,and the count of leukocyte.Except for age and gender,there were significant differences between the two groups(P<0.05).And the Logistic linear regression analysis indicated that location of fecal stone impaction,time of conservative treatment,ascites,persistent abdominal pain,whether the intestine expanded or not,and the count of leukocyte could be used as the important reference factors to determine whether patients need surgical treatment(P<0.05).Conclusion:For patients with fecal stone ileus,multi factor analysis should be used to judge the condition of the patients and closely observe the changes of the condition of the patients.The surgical indications and proper timing should be strictly controlled to avoid delaying the patient’s condition and unnecessary surgical attack on patients who can be treated conservatively.

关 键 词：粪石 肠梗阻 手术指征 

分 类 号：R574.2[医药卫生—消化系统]