内科

目的探究急性黏连性小肠梗阻（AASIO）保守治疗无效的影响因素。方法回顾性分析108例接受保守治疗的AASIO患者的临床资料，应用多因素logistic回归模型分析AASIO保守治疗无效的影响因素。结果108例AASIO患者中，83例患者经保守治疗有效（有效组），25例患者经保守治疗无效（无效组）。与无效组比较，有效组中有发热症状患者占比低于无效组，白细胞计数≤9.5×109个/L患者占比、C反应蛋白水平≤8.2 mg/L患者占比、降钙素原水平≤0.05 ng/mL患者占比、扩张肠管最大外径≤3.50 cm患者占比、保守治疗时间≤7 d患者占比均高于无效组（均P＜0.05）。多因素logistic回归分析结果显示，有发热症状、肠管扩张最大外径>3.50 cm和保守治疗时间>7 d为AASIO保守治疗无效的独立危险因素（均P＜0.05）。结论发热、扩张肠管最大外径和保守治疗时间是AASIO保守治疗无效的影响因素。

ObjectiveTo investigate influencing factors for the ineffectiveness of conservative therapy in acute adhesive small intestine obstruction (AASIO). MethodThe clinical data of 108 patients with AASIO who received the conservative therapy were retrospectively analyzed, and a multivariate logistic regression model was used to analyze influencing factors for the ineffectiveness of conservative therapy in AASIO. ResultsAmong the 108 patients with AASIO, 83 patients responded to the conservative therapy (effective group) and 25 patients did not respond to the conservative therapy (ineffective group). The proportion of patients with fever in the effective group was lower than that in the ineffective group, and the proportions of patients with a white blood cell count ≤9.5×109/L, a C-reactive protein level ≤8.2 mg/L, a procalcitonin level ≤0.05 ng/mL, a maximum dilated bowel diameter≤ 3.50 cm, and conservative therapy time ≤7 days in the effective group were higher than those in the ineffective group (all P＜0.05). The results of the multivariate logistic regression analysis showed that fever, a maximum dilated bowel diameter>3.50 cm, and conservative therapy time >7 days were independent risk factors for the ineffectiveness of conservative therapy in AASIO (all P＜0.05). ConclusionFever, maximum dilated bowel diameter, and conservative therapy time are influencing factors for the ineffectiveness of conservative therapy in AASIO.