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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Small Bowel Obstruction in the Virgin Abdomen: A Retrospective Study for a New Management Pathway
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Small Bowel Obstruction in the Virgin Abdomen: A Retrospective Study for a New Management Pathway

机译：处女腹部的小肠梗阻：新管理途径的回顾性研究

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Adhesions are the main cause of Small Bowel Obstruction (SBO) for patients with previous abdominal surgery. In this case, conservative management has traditionally been efficient. However, aetiologies and therapeutic decisions are less obvious to determine for patients without previous abdominal surgery.Aim: To identify the accuracy of the results of clinical findings, laboratory investigations and Computed Tomography (CT) scan as tools to suggest a management pathway to deal with SBO in the virgin abdomen.Materials and Methods: This retrospective study included 59 patients that had been admitted for SBO with a virgin abdomen between January 2008 and December 2016. Clinical, laboratory and radiological findings were assessed to determine the difference between the urgent surgical versus the non operative management groups. Statistical analyses were performed using SPSS version 24.0. Logistic regression was used to determine the independent predictive factor of an urgent surgery.Results: Overall, 59 patients with no prior abdominal surgery were admitted to Department. There were 37 males and 22 females. The median age was 52 years. The CT scan performed in 52 cases, revealed the cause of obstruction in 35 cases (67.30%). The most common cause of obstruction was Crohna€?s disease present in 13 cases (22.03%). Twenty-nine patients (49.15%) underwent surgery. A rate of C-Reactive Protein (CRP) >135 mg/L was an independent predictor of an urgent surgery {p-value=0.010; OR=1.009 ; IC=95% (1.001-1.018)}.Conclusion: Although there was compelling evidence that the CT scan was essential in the management pathway, it was not accurate in the present study in terms of determining the causes of obstruction and predicting the need for performing urgent surgery. A rate of CRP =135 mg/L was a predictive factor of urgent surgery.
机译：粘连是前腹部手术患者小肠梗阻（SBO）的主要原因。在这种情况下，保守管理传统上具有高效。然而，在没有先前的腹部外科的患者确定患者，疾病和治疗决策不太明显。 STBO在Virgin Abdomen.Materials和方法：这项回顾性研究包括59名患者，该患者于2008年1月至2016年1月至12月期间被禁用。评估了临床，实验室和放射性调查，以确定紧急外科对的差异非操作管理组。使用SPSS版本24.0进行统计分析。逻辑回归用于确定紧急手术的独立预测因素。结果：总体而言，59名没有现有腹部手术的患者被录取为部门。有37个男性和22名女性。中位年龄为52岁。 CT扫描在52例中进行，揭示了35例（67.30％）的阻塞原因。梗阻最常见的原因是13例（22.03％）存在的Crohna€？二十九名患者（49.15％）进行手术。 C反应蛋白（CRP）> 135mg / L的速率是紧急手术的独立预测因子{P值= 0.010;或= 1.009; IC = 95％（1.001-1.018）}。结论：虽然有令人信服的证据表明CT扫描在管理途径中是必不可少的，但在确定障碍物的原因和预测需要的方面，本研究不准确进行紧急手术。 CRP = 135mg / L的速率是紧急手术的预测因素。

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