全身炎症反应综合征—粘连性小肠梗阻手术治疗的独立预测因子

目的研究全身炎症反应综合征(SIRS)作为粘连性小肠梗阻(ASBO)手术治疗独立预测因子的可行性。方法回顾性分析524例诊断为ASBO的患者资料,按照手术与否分为手术组(n=254)和非手术组(n=270)主要分析对比SIRS的每个变量(体温T,心率HR,呼吸R,白细胞WBC);SIRS因子的数量(0,1,2,3,4);SIRS(是或否)、患者年龄、性别等因素。结果 SIRS诊断指标中T、HR、R、WBC阳性与否,与是否进行手术治疗密切相关,手术组与非手术组χ2检验差异均有统计学意义(P<0.05)。SIRS检验阳性参数项每增加1项,患者进行手术的风险增加2.444倍(OR=2.444);SIRS检验阳性患者需要进行手术的风险是阴性的3.043倍(OR=3.043)。结论 SIRS可作为判断是否对ASBO患者进行手术治疗的预测因子,用以指导对于ASBO患者在临床治疗中是否手术治疗及手术时机的选择。

Objective To research the feasibility of regarding systemic inlfammatory response syndrome （SIRS） as an independent predictor of adhesive small bowel obstruction （ASBO） surgical treatment.Methods Retrospectively analyzed the patient data of 524 cases with adhesive small bowel obstruction （ASBO） diagnosed intraoperatively, divided them into the surgery group（254 cases）and non- surgery group（270 cases）according to whether to take an operation or not then mainly analyzed and contrasted each variable of SIRS （Temperature T, Heart rate HR, Respiration R, White blood cells WBC） , the number of SIRS factors （0, 1, 2, 3, 4 ）, whether SIRS patient or not, the age and sexuality of the patient and other factors. Results The diagnosis indexes of SIRS, T, HR, R, WBC, are positive or not is closely related to whether to have a surgical treatment, the Chi square test of surgery group and non- surgery group isP〈0.05. Each additional one of SIRS test positive parameters will make the surgical risk increase 2.444 times（OR=2.444）. The risk of SIRS tested positive is 3.043（OR=3.043）times as large as the negative for the need for surgery.Conclusion SIRS can be used as a predictive factor to judge whether to have a surgical treatment for patients suffered from ASBO, and can be used to guide whether to have a surgical treatment to the patients suffered from ASBO and the choice of surgical time in the clinical treatment.