Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
http://jmums.mazums.ac.ir
1
admin
1735-9260
1735-9279
fa
jalali
1405
2
1
gregorian
2026
5
1
36
257
online
1
fulltext
fa
بررسی عوامل خطر عود انسداد روده ی ناشی از چسبندگی در بیمارستان های منتخب آموزشی اهواز
Identifying the Risk Factors for Adhesive Small Bowel Obstruction in Selected Educational Hospitals in Ahvaz
جراحی عمومی
General surgery
گزارش کوتاه
Brief Report
<span style="line-height:2;"><span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" koodak="" lang="FA" style="font-family:"><span style="letter-spacing:-.2pt">سابقه و هدف:</span></span></b> <span b="" lang="FA" style="font-family:" zar="">مدیریت چسبندگی روده باریک ایجادکننده انسداد و تعیین عوامل خطر عود از اهمیت بالایی برخوردار است. این مطالعه با هدف تعیین عوامل خطر عود در بیماران مبتلا به انسداد روده باریک ناشی از چسبندگی بستری در بیمارستان</span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="FA" style="font-family:" zar="">های منتخب آموزشی اهواز، انجام پذیرفت.</span><span b="" lang="FA" roya="" style="font-family:"><span style="letter-spacing:-.2pt"></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" koodak="" lang="AR-SA" style="font-family:"><span style="letter-spacing:-.2pt">مواد و روش </span></span></b><b><span b="" koodak="" lang="FA" style="font-family:"><span style="letter-spacing:-.2pt"></span></span></b><b><span b="" koodak="" lang="AR-SA" style="font-family:"><span style="letter-spacing:-.2pt">ها:</span></span></b> <span b="" lang="FA" style="font-family:" zar="">این پژوهش یک مطالعه</span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="FA" style="font-family:" zar="">ی توصیفی و تحلیلی از نوع گذشته نگر بود. جامعه آماری این پژوهش افراد مراجعه</span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="FA" style="font-family:" zar="">کننده به اورژانس جراحی بیمارستان</span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="FA" style="font-family:" zar="">های گلستان و امام خمینی از سال 1397 تا 1402 بود (حجم نمونه 250 نفر). پژوهشگران به واحد مدارک پزشکی بیمارستان</span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="FA" style="font-family:" zar="">های مربوطه مراجعه و اطلاعات مربوط به متغیرهای پژوهش در فرم جمع آوری اطلاعات وارد گردید. </span><span b="" lang="AR-SA" style="font-family:" zar="">اطلاعات توسط نرم</span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="AR-SA" style="font-family:" zar="">افزار </span><span dir="LTR" style="font-size:10.0pt">SPSS</span><span b="" lang="AR-SA" style="font-family:" zar=""> نسخه 27 و آزمون</span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="AR-SA" style="font-family:" zar="">های تحلیلی </span><span dir="LTR" style="font-size:10.0pt">T</span><span b="" lang="AR-SA" style="font-family:" zar=""> مستقل، کای مربع و رگرسیون لجستیک آنالیز گردید.</span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.2pt"></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" koodak="" lang="AR-SA" style="font-family:"><span style="letter-spacing:-.2pt">یافته</span></span></b><b><span b="" koodak="" lang="FA" style="font-family:"><span style="letter-spacing:-.2pt"></span></span></b><b><span b="" koodak="" lang="AR-SA" style="font-family:"><span style="letter-spacing:-.2pt">ها:</span></span></b> <span b="" lang="FA" style="font-family:" zar="">نتایج نشان داد که </span><span b="" lang="AR-SA" style="font-family:" zar="">درصد فراوانی انجام جراحی شکمی اورژانسی </span><span b="" lang="FA" style="font-family:" zar="">(0/001</span><span dir="LTR" style="font-size:10.0pt">P= </span><span b="" lang="FA" style="font-family:" zar="">)</span><span b="" lang="AR-SA" style="font-family:" zar="">، سابقه</span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="AR-SA" style="font-family:" zar="">ی جراحی متعدد شکمی </span><span b="" lang="FA" style="font-family:" zar="">(0/004</span><span dir="LTR" style="font-size:10.0pt">P= </span><span b="" lang="FA" style="font-family:" zar="">) در گروه عود کرده به</span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="FA" style="font-family:" zar="">طور معنی</span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="FA" style="font-family:" zar="">دار بیشتر از گروه فاقد عود بود. بین </span><span b="" lang="AR-SA" style="font-family:" zar="">مدت عمل </span><span b="" lang="FA" style="font-family:" zar="">(0/001</span><span dir="LTR" style="font-size:10.0pt">P= </span><span b="" lang="FA" style="font-family:" zar="">)،</span><span b="" lang="AR-SA" style="font-family:" zar=""> مدت زمان ریکاوری </span><span b="" lang="FA" style="font-family:" zar="">(0/003</span><span dir="LTR" style="font-size:10.0pt">P= </span><span b="" lang="FA" style="font-family:" zar="">)،</span><span b="" lang="AR-SA" style="font-family:" zar=""> میزان عفونت </span><span b="" lang="FA" style="font-family:" zar="">(0/002</span><span dir="LTR" style="font-size:10.0pt">P= </span><span b="" lang="FA" style="font-family:" zar="">)</span><span b="" lang="AR-SA" style="font-family:" zar="">، میزان خون از دست رفته </span><span b="" lang="FA" style="font-family:" zar="">(0/001</span><span dir="LTR" style="font-size:10.0pt">P= </span><span b="" lang="FA" style="font-family:" zar="">)</span><span b="" lang="AR-SA" style="font-family:" zar="">، </span><span b="" lang="FA" style="font-family:" zar="">وضعیت روده ها (0/015</span><span dir="LTR" style="font-size:10.0pt">P= </span><span b="" lang="FA" style="font-family:" zar="">)</span><span b="" lang="AR-SA" style="font-family:" zar=""> و تعداد باندهای چسبنده </span><span b="" lang="FA" style="font-family:" zar="">(0/019</span><span dir="LTR" style="font-size:10.0pt">P= </span><span b="" lang="FA" style="font-family:" zar="">) </span><span b="" lang="AR-SA" style="font-family:" zar="">بین دو گروه عود کرده و فاقد عود تفاوت آماری معنی</span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="AR-SA" style="font-family:" zar="">داری وجود داشت. </span><span b="" lang="FA" style="font-family:" zar="">تجزیه و تحلیل چند متغیره لجستیک نشان داد که سابقه جراحی اورژانسی شکم (0/05</span>≥ <span dir="LTR" style="font-size:10.0pt">P</span><span b="" lang="FA" style="font-family:" zar="">)، </span><span b="" lang="AR-SA" style="font-family:" zar="">سابقه</span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="AR-SA" style="font-family:" zar="">ی جراحی متعدد شکمی </span><span b="" lang="FA" style="font-family:" zar="">(0/05</span>≥ <span dir="LTR" style="font-size:10.0pt">P</span><span b="" lang="FA" style="font-family:" zar="">) عوامل خطر مستقل برای عود بودند.</span><span b="" lang="AR-SA" style="font-family:" zar=""><span style="letter-spacing:-.2pt"></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" koodak="" lang="FA" style="font-family:"><span style="letter-spacing:-.1pt">استنتاج:</span></span></b> <span b="" lang="FA" style="font-family:" zar=""><span style="color:black">سابقه جراحی اورژانسی شکم و انجام جراحی</span></span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black">های متعدد شکم از عوامل خطر مستقل عود انسداد ناشی از چسبندگی روده باریک است. میزان بروز عوارض بعد از عمل در افراد دچار عود چسبندگی روده باریک به</span></span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black">طور معنی</span></span><span b="" lang="AR-SA" style="font-family:" zar=""></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black">داری بالاتر بود. توجه به موارد فوق برای غربالگری عوامل خطر بالا در این بیماران می تواند موثر باشد.</span></span></span></span></span></span></span>
<span style="line-height:2;"><span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="letter-spacing:-.1pt">Background and purpose:</span></span></span></b> <span style="font-size:10.0pt">Adhesive small bowel obstruction and its recurrence represent a significant clinical challenge in general surgery. The identification of associated risk factors is essential for improving patient outcomes and reducing recurrence rates. This study aimed to determine the risk factors for recurrence in patients with adhesive small bowel obstruction admitted to selected educational hospitals in Ahvaz.</span></span></span><br>
<span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Materials and methods:</span></span></span></b> <span lang="EN" style="font-size:10.0pt">This was a retrospective descriptive-analytical study. The study population included patients admitted to the surgical emergency departments of Golestan and Imam Khomeini hospitals between 2018 and 2023 (n = 250). Medical records were reviewed, and relevant clinical and demographic data were extracted using a structured data collection form. Data were analysed using SPSS version 27 software . Independent t-tests, chi-square tests, and logistic regression analysis were performed.</span></span></span><br>
<span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Results:</span></span></span></b><b> </b><span lang="EN" style="font-size:10.0pt">The results showed that the frequency of emergency abdominal surgery (P= 0.001) and a history of multiple abdominal surgeries (P= 0.004) were significantly higher in the recurrence group compared with the non-recurrence group. In addition, statistically significant differences were observed between the two groups in recovery time (P= 0.003), infection rate (P= 0.002), blood loss (P= 0.001), intestinal condition (P= 0.015), and number of adhesion bands (P= 0.019). However, multivariate logistic regression analysis indicated that only a history of emergency abdominal surgery and a history of multiple abdominal surgeries were independent predictors of recurrence (P< 0.05).</span></span></span><br>
<span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="letter-spacing:-.1pt">Conclusion:</span></span></span></b> <span lang="EN" style="font-size:10.0pt"><span style="letter-spacing:-.1pt">A history of emergency abdominal surgery and multiple prior abdominal operations are independent predictors of recurrence in adhesive small bowel obstruction. Patients with recurrent adhesive small bowel obstruction also experienced higher rates of postoperative complications. These findings highlight the importance of identifying high-risk patients to improve surveillance and preventive strategies.</span></span></span></span></span>
چسبندگی, روده باریک, عود, پیشآگهی, جراحی, ایران
adhesion, small intestine, recurrence, prognosis, surgery, Iran
141
147
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-14336-8&slc_lang=fa&sid=1
Fardis
Salmanpour
فردیس
سلمان پور
fardis.salmanpour@gmail.com