静脉注射的特兰胺酸与在肉瘤切除后肺栓塞的风险增加有关
Devon Foster1, Ronnie Sebro1,2, Hillary Garner2
1Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida, USA.
Journal of surgical oncology
|July 10, 2023
概括
在瘤手术中使用胺酸 (TXA) 与深静脉血栓形成和肺栓塞的风险增加有关. 在这种患者群体中使用TXA时建议谨慎使用,因为可能会出现血栓性并发症.
科学领域:
- 在瘤学瘤学.
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 特兰胺酸 (TXA) 是一种抗纤维解质药物,通常用于减少手术中流失的血液.
- 它的安全性和有效性已在各种骨科手术中得到证实,但其在骨科肉瘤手术中的应用尚未明确.
- 癌症相关的血栓形成是肉瘤患者的一个主要问题,而术后TXA对术后血栓性并发症的影响尚不清楚.
研究的目的:
- 为了比较手术后血栓并发症的风险,在肉瘤切除期间接受TXA的患者与没有接受TXA的患者.
- 评估手术内TXA使用与特定的血栓事件和肉瘤手术后死亡率之间的关联.
主要方法:
- 在2010年至2021年间,对1099名接受了肉瘤切除术的患者进行了回顾性审查.
- 基线人口统计和90天术后结果的比较,这些患者接受了手术内TXA和那些没有接受的患者.
- 评估并发症率,包括深静脉血栓塞 (DVT),肺栓塞 (PE),心肌梗塞 (MI),脑血管事故 (CVA) 和死亡率.
主要成果:
- 在无变量分析中,术内使用TXA与术后DVT (OR:2.22) 和PE (OR:4.62) 的显著增加有关.
- 多变量分析证实TXA与更高PE风险独立相关 (OR:10.64).
- 在术后90天内没有观察到CVA,MI或死亡率的显著增加,与TXA使用.
结论:
- 在瘤手术中使用TXA与肺栓塞的风险增加有关.
- 由于增加了血栓形成风险,建议在接受肉瘤切除的患者中给予TXA时谨慎.
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