在前列腺的holmium核化后重新定义临床显著的血
Laena Hines1, Karen M Doersch1, Mark Ninomiya2
1Department of Urology, University of Rochester Medical Center, Rochester, New York, USA.
Journal of endourology
|September 19, 2023
概括
前列腺的霍尔激光核化 (HoLEP) 可以导致临床显著的血 (CSH) 在18%的患者,影响他们的护理. 抗凝固剂和抗血小板剂显著增加这种风险,需要患者咨询.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
背景情况:
- 前列腺的霍尔激光核化 (HoLEP) 是治疗症状性前列腺扩大的一种常见治疗方法.
- 在HoLEP后临床显著的血 (CSH) 的现有定义是狭窄的,通常仅限于输血或显著的血红蛋白下降.
- 更广泛的CSH定义可能更好地捕捉经历改变临床过程的患者.
研究的目的:
- 评估与 HoLEP 后临床显著出血症 (CSH) 的更广泛定义相关的风险因素.
- 评估抗凝剂和抗血小板剂对HoLEP后CSH发育的影响.
主要方法:
- 分析了2020年11月至2023年4月期间接受HoLEP治疗的164名患者的潜在数据库.
- CSH被广泛定义为包括凝块保留,返回OR,由于出血症而发生的术后管理变化或持续的大型出血症.
- 进行了单变量和多变量分析,控制年龄,核化时间和前列腺体积.
主要成果:
- 17.7%的患者在扩大定义下发展出CSH.
- 较长的核化时间是CSH的轻微风险因素 (OR1.01,p=0.02).
- 使用抗凝血剂或抗血小板剂是CSH最强的预测因素 (多变量OR2.34,p<0.02).
结论:
- 当应用更广泛的定义时,显著比例的患者在HoLEP后经历了CSH.
- 目前对CSH的狭定义可能低估了其临床影响.
- 抗凝剂和抗血小板剂是HoLEP后CSH的重要危险因素,需要对患者进行仔细的咨询.
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