透析患者进行中枢置换的假肢选择
Amit Iyengar1, Cindy Song2, Noah Weingarten1
1Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
The Annals of thoracic surgery
|May 28, 2023
概括
在透析患者中,中枢置换的早期死亡率很高. 假肢选择没有影响存活率,但机械门增加了中风风险,而生物假肢门导致故障的重新干预.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏外科手术 心脏外科手术
背景情况:
- 透析患者具有很高的并发病率和有限的预期寿命.
- 加快的假体膜退化在这个人群中是令人担忧的.
- 了解假肢选择的影响对于优化结果至关重要.
研究的目的:
- 检查机械与生物假肢假肢选择对结果的影响.
- 分析透析患者进行中枢置换术 (MVR) 的死亡率,膜衰竭率和再干预率.
主要方法:
- 在2002年至2019年期间接受MVR的成年患者的回顾性审查.
- 纳入标准:有记录的功能衰竭和需要透析.
- 主要结局:死亡,重复严重的门衰竭,或重复中手术.
主要成果:
- 177名透析患者接受了MVR; 66.7%接受了生物假体门,33.3%的机械门.
- 机械接收者比较年轻,糖尿病也较少.
- 五年死亡率或再干预率没有显著差异;机械门与较高的中风率有关.
- 在两组中都观察到高早期死亡率 (<50%的2年生存率).
结论:
- 在透析患者中,中枢置换与显著的发病率和中期死亡率的增加有关.
- 假肢选择需要仔细考虑个体患者的预期寿命.
- 定制对透析依赖患者的假肢选择至关重要.
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