60例医源性结直肠穿孔患者临床特征及治疗策略、转归分析  

Clinical features,treatment strategies,and outcomes in 60 patients with iatrogenic colorectal perforation

作　　者：钟佳 夏国盛 黄道斌 Zhong Jia;Xia Guo-sheng;Huang Dao-bin(Department of Gastroenterology,Ji'an Central People's Hospital,Ji'an 343000,Jiangxi,China;Department of General Surgery,Ji'an Central People's Hospital,Ji'an 343000,Jiangxi,China)

机构地区：[1]吉安市中心人民医院消化内科,江西吉安343000 [2]吉安市中心人民医院普外科,江西吉安343000

出　　处：《四川生理科学杂志》2024年第11期2386-2388,2483,共4页

基　　金：吉安市科技计划项目(20244-049156)。

摘　　要：目的:分析60例医源性结直肠穿孔患者临床特征及治疗策略、转归情况。方法:回顾性收集2014年1月到2024年6月于吉安市中心人民医院收治的60例医源性结直肠穿孔患者临床资料,根据治疗方式不同分为外科治疗组(行手术治疗)41例、内科治疗组(行内科保守治疗)19例,追踪随访6m,比较两组治疗后初始进食时间、住院时间、住院期间并发症情况,统计患者出院后6 m转归情况,对转归优良及转归不佳患者开展Logistic回归分析,分析影响医源性结直肠穿孔患者转归的相关因素。结果:外科治疗组进食时间、住院时间短于内科治疗组(P<0.05);两组住院期间并发症发生率比较无统计学意义(P>0.05);经统计,出院后6m,60例患者中转归不佳者占比28.33%(17/60),经单因素与多因素分析,医源性结直肠穿孔患者年龄、损伤至治疗时间、治疗方式、治疗期间并发症均为影响转归的独立影响因素(P<0.05)。结论:医源性结直肠穿孔患者存在个体化差异,临床制定治疗策略时需进行全方位考量,其中外科治疗优势相对更显著,且患者转归受年龄、损伤至治疗时间、治疗方式、治疗期间并发症影响,临床可针对以上因素采取对应措施,促进预后恢复。Objective:To analyze the clinical features,treatment strategies,and outcomes in 60 patients with iatrogenic colorectal perforation.Methods:The clinical data of 60 patients with iatrogenic colorectal perforation admitted to Ji'an Central People's Hospital from January 2014 to June 2024 were collected retrospectively.According to different treatment methods,included patients were divided into the surgical treatment group(surgery,41 cases)and the medical treatment group(conservative medical treatment,19 cases).All patients were followed up for 6 months.After treatment,initial feeding time,length of hospital stay,and complications during hospitalization were compared between the two groups.Patients'outcomes at 6 months after discharge were statistically analyzed.Logistic regression analysis was conducted to screen the factors affecting outcomes of patients with iatrogenic colorectal perforation.Results:Feeding time and hospital stay of the surgical treatment group were shorter than those of the medical treatment group(P<0.05).The incidence rates of complications during hospitalization showed no statistically significant difference between the two groups(P>0.05).Six months after discharge,there were 60 patients with poor outcomes,accounting for 28.33%.Univariate analysis and multivariate analysis found that age,the time from injury to treatment,treatment method,and complications during treatment were independent influencing factors of outcomes in patients with iatrogenic colorectal perforation(P<0.05).Conclusion:Individualized differences exist in patients with iatrogenic colorectal perforation.Comprehensive consideration is necessary when formulating treatment strategies in clinical practice,and surgical treatment has more advantages.Patients’outcomes are influenced by age,the time from injury to treatment,treatment method,and complications during treatment.In clinical practice,corresponding measures can be taken to improve the prognosis.

关 键 词：医源性结直肠穿孔 临床特征 治疗策略 转归 

分 类 号：R574[医药卫生—消化系统]