Anorectal surgery in the HIV+ patient: Update

Anorectal surgery in the HIV+ patient: Update
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HIV 患者的肛门直肠手术:更新

DOI:
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发表时间:
1991
影响因子:
3.9
通讯作者:
T. H. Dailey
T. H. Dailey
中科院分区:
医学2区
文献类型:
--
作者:
A. Safavi;L. Gottesman;T. H. Dailey

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历史上,对HIV阳性患者进行肛门直肠手术一直被视为虚无主义。医学治疗的进步和对独特病理生理过程的更好理解使结直肠外科医生能够更好地治疗,有时甚至治愈艾滋病的肛门直肠并发症。我们提出了一系列的75个连续的外科手术(1年累计)的HIV+(40)和CDC艾滋病(22)患者。将介绍手术过程、围手术期T细胞计数和结局; 53%的手术导致肛门伤口完全愈合; 30%的手术导致部分愈合,症状缓解; 17%的手术导致症状缓解或组织诊断,但伤口没有明显愈合。HIV+组的治愈率(69%)明显高于艾滋病组(26%)。围手术期T细胞计数对预后无预测价值。没有患者发生显著的意外发病率、死亡率或尿失禁。一些疾病过程中独特的HIV+患者和我们正在进行的调查使用RNA杂交的数据的病理生理机制。
Anorectal surgery in HIV+patients historicially has been viewed with a great deal of nihilism. Advances in medical therapy and better understanding of unique pathophysiologic processes have afforded the colorectal surgeon the ability to treat better and sometimes cure the anorectal complications of AIDS. We present a series of 75 consecutive surgical procedures (1-year accrual) on HIV+(40) and CDC AIDS (22) patients. Surgical procedures, perioperative T cell counts, and outcome will be presented; 53 percent of procedures resulted in complete healing of anal wounds; 30 percent resulted in partial healing with symptomatic relief; 17 percent resulted in symptomatic relief or tissue diagnosis without appreciable wound healing. The healing rate was significantly higher in the HIV+group (69 percent) compared to the AIDS group (26 percent). Perioperative T cell counts did not have predictive value on outcome. No patients suffered significant unexpected morbidity, mortality, or incontinence. Pathophysiologic mechanisms of several disease processes unique to HIV+patients and data from our ongoing investigation using RNA hybridization are presented.
男同性恋者的肛门直肠和肠道感染。
DOI: --
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影响因子: --
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