背景:急性小肠梗阻(SBO)是常见的外科急症。该研究旨在提供印度西部三级护理中心成人SBO的全面临床流行病学描述。
方法:这项基于医院的横断面研究于2020年7月至2022年6月进行,纳入了88名需要手术干预的SBO患者。在充分复苏病人后,根据术中肠道情况进行各种外科手术.术后评估患者的住院时间,术后并发症,和手术恢复。
结果:男性占优势(n=55),年龄中位数为50(18-90)岁。腹部不适是最常见的症状,需要去医院就诊(97.9%,n=86),其次是恶心(85.2%,n=75),便秘(78.1%,n=69),和腹胀(51.1%,n=45)。回肠狭窄(18.2%,n=16)是最常见的病因,其次是术后粘连(14.8%,n=13)和波段(13.6%,n=12),其中76.4%(n=9)有手术史。在这项研究中,切除和吻合是最常见的手术干预措施(36.4%,n=32),其次是造口(27.3%,n=24)和粘连分解(17%,n=15)。术后30天死亡率为11.36%(n=10),这可以归因于患有合并症的老年人口,术后并发症,和谁需要在重症监护病房长期逗留。
结论:良性回肠狭窄是急诊急性SBO的最常见原因。及时及时诊断,多学科方法和有效管理可以改善成年SBO患者的预后并降低发病率和死亡率。
BACKGROUND: Acute small bowel obstruction (SBO) is a common surgical emergency. The study aims to provide a comprehensive clinical-epidemiological description of SBO in adults at a tertiary care center in western India.
METHODS: This hospital-based cross-sectional study was conducted from July 2020 to June 2022 and enrolled 88 SBO patients requiring surgical intervention. After adequately resuscitating the patients, various surgical procedures were performed based on the intraoperative conditions of the bowel. Patients were assessed postoperatively for the duration of their hospital stay, postoperative complications, and surgical recovery.
RESULTS: There was a male preponderance (n=55), with a median age of 50 (18-90) years. Abdominal discomfort was the most frequent symptom, necessitating a hospital visit (97.9%, n= 86), followed by nausea (85.2%, n= 75), constipation (78.1%, n=69), and abdominal distension (51.1%, n=45). Ileal strictures (18.2%, n=16) were the most common etiology, followed by postoperative adhesions (14.8%, n=13) and bands (13.6%, n=12), of which 76.4% (n=9) had past surgical history. Resection and anastomosis were the most frequently performed surgical interventions in this study (36.4%, n=32), followed by stoma creation (27.3%, n=24) and adhesiolysis (17%, n=15). The postoperative 30-day mortality of 11.36% (n=10) was noted, which could be ascribed to the elderly population with comorbidity, postoperative complications, and who required extended stay in the critical care unit.
CONCLUSIONS: Benign ileal stricture was the most common cause of acute SBO in the emergency. Prompt and timely diagnosis combined with a multidisciplinary approach and effective management can improve outcomes and reduce morbidity and mortality in adult patients with SBO.