在COVID-19患者中活跃动脉出血的栓塞:一个多中心研究
Hannah L Steinberg1, Timo A Auer2, Bernhard Gebauer3
1Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Essen, Germany.
European journal of radiology
|June 3, 2023
概括
穿动脉栓塞在COVID-19患者的动脉出血中有效. 然而,需要ECMO治疗的患者面临更低的存活率和更高的再出血风险,而抗凝固药对死亡率没有影响.
科学领域:
- 干预性放射学 干预性放射学
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
背景情况:
- 动脉出血是严重的COVID-19的一个严重并发症.
- 超动脉栓塞 (TAE) 是一种潜在的治疗选择,用于控制动脉出血.
- 了解接受TAE的COVID-19患者的结果对于临床决策至关重要.
研究的目的:
- 评估COVID-19患者对动脉出血的跨动脉栓塞的疗效和安全性.
- 为了比较不同患者亚组之间的生存率,特别是那些需要ECMO治疗和抗凝药的患者.
主要方法:
- 对接受动脉出血TAE的COVID-19患者进行回顾性多中心研究 (2020年4月 - 2022年7月).
- 分析技术成功,30天生存率和再出血事件.
- 基于ECMO治疗和抗凝血状态的结果的统计比较,使用奇方位和费舍尔精确测试.
主要成果:
- 在53名COVID-19患者中,98.1%的TAE在技术上是成功的.
- 与没有ECMO (86.4%;p=0.004) 的患者相比,需要ECMO治疗的患者的30天生存率 (45.2%) 显著降低 (86.4%;p=0.004).
- 经过ECMO治疗的患者在栓塞后出现更高的复出出血率 (32.3%与4.5%相比;p=0.02). 抗凝药没有显著影响30天生存率.
结论:
- 穿动脉栓塞是COVID-19患者动脉出血的安全有效干预措施.
- ECMO治疗与预后较差有关,包括TAE后生存率降低和再出血风险增加.
- 在这个队列中,抗凝血疗法没有被确定为增加死亡率的风险因素.
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