外源性替代疗法与高阴性男性血管移植感染风险增加有关
Kaohinani J Longwolf1, Cali E Johnson1, Joshua J Horns2
1Division of Vascular Surgery, Department of Surgery, University of Utah Health, Salt Lake City, UT.
Annals of vascular surgery
|July 15, 2023
概括
接受替代疗法 (TRT) 的低性男性在手术后患血管移植感染 (VGI) 的风险更高. 在假肢移植之前暂时停止TRT可能会降低VGI风险,特别是在下肢手术中.
科学领域:
- 血管外科 血管外科
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
背景情况:
- 血管移植感染 (VGIs) 是血管旁路手术后的一个重要并发症.
- 阴性腺症可能会影响伤口愈合并增加感染风险,但替代疗法 (TRT) 的效果尚不清楚.
研究的目的:
- 为了评估下性,TRT使用和发展VGI的风险之间的关联.
- 为了确定TRT是否减轻或加剧接受假肢移植手术的阴茎男性的感染风险.
主要方法:
- 追溯分析MarketScan数据库 (2009-2020年) 的18岁以上的男性进行了假体动脉旁路移植.
- 在手术前180天内根据下阴性腺症诊断和TRT使用的患者分层.
- 主要结局:需要手术切除的VGI. 使用卡普兰-梅尔图和考克斯比例危险模型进行分析.
主要成果:
- 18,312名男性接受了手术;802名 (5%) 患有阴道腺缺陷症,其中251名 (31%) 接受了TRT.
- 接受TRT的男性更年轻,更可能患有糖尿病,并且具有更高的VGI率 (14%与8%,P<0.001),特别是在下肢.
- 经过调整的考克斯模型显示,与对照组相比,接受TRT的阴阴腺男性的VGI风险显著增加 (HR: 1.94,95%CI: 1.4-2.7,P < 0.001).
结论:
- 替代疗法在低子的男性与假体血管移植感染的风险增加有关.
- 对于接受假肢移植的男性,特别是对于下肢手术,应该考虑暂时停止TRT.
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