胃肠结石治疗决策树的研究——基于安徽省51例胃肠结石患者的临床数据分析

Decision tree for the treatment of gastrointestinal bezoars based on the clinical data analysis of 51 patients with gastrointestinal bezoars in Anhui Province

摘要:

目的 通过构建胃肠结石治疗决策树，优化胃肠结石的治疗效果。方法 回顾性分析2010年1月—2022年12月中国科学技术大学附属第一医院收治的51例胃肠结石患者的病历资料，并据此绘制胃肠结石的治疗决策树。结果 51例患者中，20例有急性表现的患者经手术治疗取得成功。31例无急性表现的患者中，4例为罕见结石（毛发结石），其中1例通过内镜治疗获得成功，3例通过手术治疗获得成功；另外27例为常见结石（主要为植物结石），其中药物治疗成功7例，内镜治疗成功17例，手术治疗成功3例。结论 根据绘制的胃肠结石治疗决策树，发现对于有急性表现的胃肠结石患者，首选手术治疗；对于无急性表现的罕见结石患者，尽管有内镜治疗成功的个案，但首选仍为手术治疗；对于无急性表现的常见结石患者，则首先考虑药物和内镜治疗，若这2种方法无效，则推荐手术治疗。

Abstract:

Objective To construct a decision tree for the treatment of gastrointestinal bezoars, aiming to optimize the treatment outcomes for these conditions.Methods A retrospective analysis was conducted on the medical records of 51 patients with gastrointestinal bezoars treated in the First Affiliated Hospital of University of Science and Technology of China from January 2010 to December 2022, and a decision tree for the treatment gastrointestinal bezoars was developed based on these data.Results Among the 51 patients, 20 patients with acute presentations were all successfully treated surgically. Of the 31 patients without acute presentations, 4 had rare bezoars (trichobezoars), among whom 1 was successfully treated with endoscopic therapy, and 3 were successfully treated surgically. The remaining 27 had common bezoars (mainly phytobezoars), with 7 successfully treated with medications, 17 with endoscopic therapy, and 3 with surgery.Conclusions According to the decision tree for the treatment of gastrointestinal bezoars, we found that surgical treatment is the preferred option for patients with acute presentations of gastrointestinal bezoars. For patients with rare bezoars without acute presentations, despite successful cases of the endoscopic therapy, surgery remains the preferred treatment. For patients with common bezoars without acute presentations, medication and endoscopic therapy should be considered first, and surgical treatment is recommended when they are ineffective.