Acute mesenteric vein thrombosis (AMVT) is an acute abdominal disease with onset, rapid progression, and extensive intestinal necrosis that requires immediate surgical resection. The purpose of this study was to determine the risk factors for nosocomial intestinal resection in patients with AMVT. We retrospectively analysed 64 patients with AMVT diagnosed by CTA at the Affiliated Hospital of Kunming University of Science and Technology from January 2013 to December 2021. We compared patients who underwent intestinal resection (42 patients) with those who did not undergo intestinal resection (22 patients). The area under the ROC curve was evaluated, and a forest map was drawn. Among the 64 patients, 6 (9.38%) had a fever, 60 (93.75%) had abdominal pain, 9 (14.06%) had a history of diabetes, 8 (12.5%) had a history of deep vein thrombosis (DVT), and 25 (39.06%) had ascites suggested by B ultrasound or CT after admission. The mean age of all patients was 49.86 ± 16.25 years. The mean age of the patients in the enterectomy group was 47.71 ± 16.20 years. The mean age of the patients in the conservative treatment group (without enterectomy) was 53.95 ± 15.90 years. In the univariate analysis, there were statistically significant differences in leukocyte count (P = 0.003), neutrophil count (P = 0.001), AST (P = 0.048), total bilirubin (P = 0.047), fibrinogen (P = 0.022) and DD2 (P = 0.024) between the two groups. The multivariate logistic regression analysis showed that admission white blood cell count (OR = 1.153, 95% CI: 1.039–1.280, P = 0.007) was an independent risk factor for intestinal resection in patients with AMVT. The ROC curve showed that the white blood cell count (AUC = 0.759 95% CI: 0.620–0.897; P = 0.001; optimal threshold: 7.815; sensitivity: 0.881; specificity: 0.636) had good predictive value for emergency enterectomy for AMVT. Among patients with AMVT, patients with a higher white blood cell count at admission were more likely to have intestinal necrosis and require emergency enterectomy. This study is helpful for clinicians to accurately determine whether emergency intestinal resection is needed in patients with AMVT after admission, prevent further intestinal necrosis, and improve the prognosis of patients.

中文翻译：

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急性肠系膜静脉血栓患者白细胞计数与肠切除的相关性

急性肠系膜静脉血栓形成（AMVT）是一种急性腹部疾病，起病迅速，进展迅速，可导致广泛肠坏死，需要立即手术切除。本研究的目的是确定 AMVT 患者院内肠切除术的危险因素。我们回顾性分析了2013年1月至2021年12月昆明理工大学附属医院经CTA诊断的64例AMVT患者。我们将接受肠切除的患者（42例）与未接受肠切除的患者（22例）进行比较。 ）。评估ROC曲线下的面积，并绘制森林图。64例患者中，6例（9.38%）有发热，60例（93.75%）有腹痛，9例（14.06%）有糖尿病病史，8例（12.5%）有深静脉血栓（DVT）病史，入院后B超或CT提示有腹水25例（39.06%）。所有患者的平均年龄为 49.86 ± 16.25 岁。肠切除术组患者的平均年龄为47.71±16.20岁。保守治疗组（未进行肠切除术）患者的平均年龄为 53.95 ± 15.90 岁。在单变量分析中，白细胞计数（P = 0.003）、中性粒细胞计数（P = 0.001）、AST（P = 0.048）、总胆红素（P = 0.047）、纤维蛋白原（P = 0.022）和DD2差异有统计学意义。 (P = 0.024) 两组之间。多因素Logistic回归分析显示，入院白细胞计数（OR=1.153，95%CI：1.039~1.280，P=0.007）是AMVT患者行肠切除的独立危险因素。ROC曲线显示白细胞计数（AUC = 0.759 95% CI：0.620–0.897；P = 0.001；最佳阈值：7.815；敏感性：0.881；特异性：0.636）对AMVT急诊肠切除术具有良好的预测价值。在 AMVT 患者中，入院时白细胞计数较高的患者更有可能出现肠坏死并需要紧急肠切除术。本研究有助于临床医生准确判断AMVT患者入院后是否需要急诊肠切除术，防止进一步肠坏死，改善患者预后。