改性超过降低了成人心脏手术后的发病率:一项前性随机临床试验
G B Luciani1, T Menon, B Vecchi
1Division of Cardiac Surgery, University of Verona, Verona, Italy. luciani@netbusiness.it
Circulation
|September 25, 2001
概括
心肺旁路术后的改性超显著降低了成人心脏手术患者的医院发病率和输血需求. 这种技术推用于例行使用,以改善患者的治疗结果.
科学领域:
- 心血管外科心血管外科
- 临界护理医学 临界护理医学
- 医疗技术 医疗技术 医学技术
背景情况:
- 在开放心脏手术期间,体外循环会触发全身炎症反应,增加患者的发病率.
- 改性超过 (MUF) 是一种技术,旨在通过去除液体过载和炎症介质来减轻这种情况.
- 虽然在儿科心脏手术中有效,但MUF对成人心脏手术的影响仍未得到研究.
研究的目的:
- 评估改性超过 (MUF) 在减少患病率和改善心脏手术需要心肺绕道手术的成年患者的治疗结果方面的疗效.
- 评估MUF对医院死亡率,特定并发症率,输血要求和住院时间的影响.
主要方法:
- 一项前性随机对照试验,涉及573名接受心脏手术的成年患者.
- 患者被随机分配,接受心肺旁路术后的MUF (治疗组) 或没有MUF (对照组).
- 使用帕森尼得分来评估临床严重性,并进行统计分析,包括学生的t测试,曼-惠特尼U测试,费舍尔的精确测试和皮尔森的Chi.
主要成果:
- 与对照组 (40.5%) (P=0.0001) 相比,MUF组 (23.2%) 的住院发病率明显较低.
- 接受治疗的患者出现的呼吸系统 (7.0%对12.5%,P=0.029),神经系统 (1.8%对4.8%,P=0.039) 和胃肠道 (0%对1.4%,P=0.044) 的并发症显著减少.
- 在MUF组中,输血需求减少 (1.66U/患者对2.25U/患者,P=0.039). 医院死亡率和心脏病发病率在各组之间没有显著差异.
结论:
- 在心肺绕道术后应用的修改过与成人心脏手术患者早期医院病率的显著降低有关.
- 这种技术还导致了血液输血需求的减少.
- 在成人心脏手术中,MUF的常规实施是有必要的,尽管需要进一步分析其对住院时间的影响.
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