创伤性闭合性胃肠破裂患者术后预后影响因素分析

Analysis of Postoperative Prognostic Factors in Patients with Traumatic Closed Gastrointestinal Rupture

目的:调查创伤性闭合性胃肠破裂患者的临床特征,并对其手术治疗情况、预后的影响因素进行分析。方法:回顾性选取2014年1月—2023年12月泗水县人民医院收治的142例创伤性闭合性胃肠破裂患者临床资料展开分析。所有病例均通过手术治疗方式探查胃肠损伤情况,并对破裂处进行妥善修补,统计术后预后情况,计算死亡率。根据手术治疗预后情况,将患者分为存活组(n=125)与死亡组(n=17),对两组的一般资料进行分析,探讨患者预后的影响因素。结果:142例患者中17例术后死亡,死亡率为11.97%。两组在受伤至入院时间、合并多发伤、红细胞比容、收缩压、碱剩余及术后并发症种类对比,差异均有统计学意义(P<0.05)。Logistic回归分析发现,受伤至入院间隔时间≥6 h、红细胞比容<40%、碱剩余<-6 mmol/L、并发症种类>2种是手术治疗后患者死亡的影响因素。结论:并发症较多及碱剩余、红细胞比容指标异常可能预示着患者面临不良结局的风险,临床应高度重视患者预后相关影响因素的管理。

Objective:To investigate the clinical features of patients with traumatic closed gastrointestinal rupture,and to analyze the operative treatment and prognostic factors.Methods:Clinical data of 142 patients with traumatic closed gastrointestinal rupture admitted to Sishui County People’s Hospital from January 2014 to December 2023 were retrospectively selected and analyzed.In all cases,the gastrointestinal injury was investigated by surgical treatment,and the rupture was properly repaired.The postoperative prognosis was calculated and the mortality was calculated.According to the prognosis,the patients were divided into a survival group(n=125)and a death group(n=17),the general data of the two groups were analyzed to explore the influencing factors of the patients’prognosis.Results:Among 142 patients,17 died after operation,the mortality rate was 11.97%.Compared with the time from injury to admission,multiple injuries,erythrocyte volume,systolic blood pressure,alkali residual and types of postoperative complications in the two groups,with statistical significance(P<0.05).Logistic regression analysis revealed that the injury-to-admission interval was≥6 h,erythrocyte specific volume was<40%,base residual<-6mmol/L,and type of complication>2 were the influencing factors of patients’death after surgical treatment.Conclusion:More complications and abnormal alkali residue and erythrocyte volume may indicate the risk of adverse outcomes in patients,and the management of prognostic factors should be attached great importance in clinical practice.