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頁籤選單縮合
題名 | Analysis on Stage Operation in Complicated Diverticulitis=論階段性手術在複雜性大腸憩室炎之必要性 |
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作者姓名(中文) | 陳芝忻; 葉建裕; 唐瑞平; 陳進勛; 謝寶秀; 洪欣園; 江支銘; 蔡文司; 游正府; 張簡俊榮; 王正儀; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 22:1 2011.03[民100.03] |
頁次 | 頁1-6 |
分類號 | 416.245 |
關鍵詞 | 複雜性大腸憩室炎; 階段性手術; 手術併發症; Colon diverticulitis; Complicated; Stage operation; Complications; |
語文 | 英文(English) |
中文摘要 | 目的 了解是否階段性手術在複雜性大腸憩室炎上有術後併發症及住院天數上的不同, 暨調查是否階段性手術會減低術後併發症,是否有術後併發症好發相關的危險因子。 方法 收集自民國89 年一月至民國92 年十二月所有因複雜性憩室炎入住長庚醫院的病 例。查詢病歷並紀錄相關資料,選擇出有因複雜性大腸憩室炎進行手術之病例,回溯其 病歷資料並紀錄相關之手術併發症,住院天數,基本資料等,再以SAS 統計軟體進行 統計分析。 結果 自民國89 年一月至民國92 年十二月,共有335 個病例因大腸憩室炎入住林口長 庚紀念醫院。其中有57 個病例有大腸鏡或大腸鋇劑攝影診斷並且非複雜性憩室炎,有 87 個病例是臨床診斷非複雜性憩室炎,92 個病例為電腦斷層診斷非複雜性憩室炎。共 有46 例診斷為複雜性憩室炎且有施行手術。在這46 例當中,有4 例 (8.7%) 為組織膿 炎 (phlegmon),有34 例 (73.9%) 為膿瘍或廔管,8 例 (17.4%) 為穿孔破裂。其中有30 例 (65.2%) 施行一階段手術,13 例 (28.3%) 施行兩階段手術,3 例 (6.5%) 施行三階 段手術。統計結果為一階段性手術和病人術後併發症有顯著相關 (p < 0.0016),階段性 手術及病人住院總天數也有顯著相關 (p < 0.00005)。 結論 在本次回溯性統計當中,發現階段性手術和病人術後併發症,及和病人住院總天 數有顯著相關。在本次統計中,不論年齡,複雜性憩室炎之分期,一階段手術的病人在 術後併發症有最低的發生風險,在總住院天數上有最好的預測值。 |
英文摘要 | Purpose. To investigate whether stage operations have better clinical outcomes with regard to morbidities and days of stay in hospital, and to investigate risk factors of morbidity in patients with complicated diverticulitis post operation. Materials and Methods. We collected general data of hospitalized patients from January 2000 to December 2003 with the diagnosis of acute diverticulitis. By reviewing their medical records, all these patients who were diagnosed and received operation for complicated diverticulitis were enrolled in this study. Further analysis on mortality, morbidity and days of hospital stay used SAS software. Results. 335 cases were diagnosed as acute diverticulitis from Jan. 2000 to Dec. 2003 at Chang Gung Memorial Hospital in Taiwan, Linko. Among these cases, 57 were uncomplicated and with colonoscopy or LGI series confirmed, 87 were clinically diagnosed, and 92 were diagnosed using CT scan. Anther 46 cases were further diagnosed not complicated diverticulitis cases (ex: cancer, ulcerative colitis, colitis…etc) by colonoscopic biopsies. Forty-six complicated diverticulitis cases which received operation were enrolled for this study; another 7 complicated diverticulitis cases were excluded due to no operation performed. We classified the complications of 46 cases as: phlegmon: 4 (8.7%), abscess or fistula 34 (73.9%) and perforation 8 (17.4%). Operation methods were: 1-stage operation 30 (65.2%); 2-stage operation 13 (28.3%) and 3-stage operation 3 (6.5%). Further analysis revealed significant relationship on operation method and morbidity (p < 0.0016), and also between operation method and hospital stay (p < 0.00005). Conclusion. In our retrospective study, stage operations have significant relation with total admission duration and operation morbidity. In our analysis, one-stage operation had lowest risk of long hospital stay and operative morbidity; moreover, operation method had significant relation with long hospital stay comparing with age, phases, lesion sites and patient conditions. |
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