在治疗儿科 iliofemoral 动脉血栓塞的实践模式
Alyssa E Vaughn1, Jessica K Hall1, Madison L Harrison1
1Division of Pediatric Surgery, Department of Surgery, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO.
Surgery
|July 28, 2023
概括
儿科骨上垂动脉血栓,主要影响婴儿,是有效地通过抗凝药,如氨酸或埃诺沙巴林管理,很少需要手术. 较短的治疗周期 (≤28天) 是安全的,不会增加长期风险.
科学领域:
- 儿科血管医学 儿科血管医学
- 血液学 血液学 血液学
- 干预性心脏病学 干预性心脏病学
背景情况:
- 急性动脉血栓形成严重的生命和肢体威胁儿童的风险.
- 由于专家的共识有限,当前的儿科大腿侧动脉血栓管理往往依赖于成年人的数据.
- 了解儿科特定的治疗模式和结果对于明智的建议至关重要.
研究的目的:
- 为了分析治疗策略和长期结果在儿科患者急性 iliofemoral动脉血栓形成.
- 为了比较接受抗凝血药治疗 ≤28天的儿童与 >28天的儿童之间的结果.
- 为了提供基于证据的治疗指南,为儿科 iliofemoral 动脉血栓形成.
主要方法:
- 对236名被诊断患有 iliofemoral动脉血栓症的儿科患者进行了回顾性研究 (2009-2018).
- 管理参数的评估,治疗持续时间 (≤28天与>28天) 和随访数据.
- 使用费舍尔精确和曼-惠特尼U测试进行统计分析.
主要成果:
- 大多数患者 (207/236) 是婴儿;中位治疗持续时间为28天.
- 较长的治疗时间 (>28天) 与推迟的血栓分辨率和更多的超声波相关.
- 肢体长度差异没有显著差异;在随访期间没有观察到外围动脉疾病. 常见的治疗方法包括与素 (25.0%) 结合的素和素单一治疗 (21.6%). 手术干预很少发生 (3.4%).
结论:
- 儿科骨上垂动脉血栓症主要是一种婴儿疾病,通过抗凝药 (氨酸/氨酸) 有效管理,很少需要手术.
- 当通过超声波确认的血栓分辨率指导时,四周或更短的抗凝血疗程是安全的.
- 这种方法不会增加手术干预或长期并发症的风险.
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