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肝病住院患者的流程相关出血 (PROC-BLeeD):一个国际,前性,多中心观察性研究
Nicolas M Intagliata1, Robert S Rahimi2, Fatima Higuera-de-la-Tijera3
1University of Virginia Health System, Charlottesville, Virginia.
Gastroenterology
|June 4, 2023
概括
住院肝硬化患者的手术出血是罕见但严重的. 高风险手术,高BMI和晚期肝病预测出血事件,而不是标准测试.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 内部医学 内部医学
背景情况:
- 患有肝硬化的住院患者通常需要多次手术.
- 在这个人群中,手术出血的风险和管理还不清楚.
研究的目的:
- 为了确定住院肝硬化患者的手术相关出血的发生率.
- 为了确定出血事件的独立风险因素.
主要方法:
- 一项国际,前性,多中心研究,涉及1187名患者,接受3006次非手术手术.
- 患者在入院后的28天内或直到重大事件发生之前被监测.
主要成果:
- 出血发生在6.9%的患者入院和3.0%的手术中;严重出血分别发生在2.3%和0.9%.
- 高风险的手术,升高的末期肝病模型 (MELD) 评分,以及更高的身体质量指数 (BMI) 独立预测出血.
- 传统的血液静止测试,预防和抗血栓剂没有预测效果.
结论:
- 在住院肝硬化患者中,手术出血不常见.
- 患有较高的BMI和不补偿性肝病的患者接受高风险手术时面临更高的出血风险.
- 标准测试或预防措施无法可靠地预测出血风险.
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