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Robot-Assisted Kidney Transplantation
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在利用分子吸附剂循环系统后,脏结果
Christopher L Trautman1, Mahnoor Khan1, Lyle W Baker1
1Division of Nephrology and Hypertension, Department of Medicine; Mayo Clinic Jacksonville, Florida, USA.
Kidney international reports
|October 18, 2023
概括
分子吸附剂循环系统 (MARS) 疗法用于严重的肝衰竭. 需要MARS的患者通常需要持续脏替代疗法 (CKRT),这与明显更高的死亡率有关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 肝病学 肝病学是一种肝病学.
- 关键护理医学 关键护理医学
背景情况:
- 突发性肝衰竭通常需要先进的体外支持,如分子吸附剂循环系统 (MARS).
- 急性损伤 (AKI) 是肝功能衰竭患者的常见并发症,通常需要持续置换疗法 (CKRT).
- 对于接受MARS治疗的患者的结局存在有限的数据.
研究的目的:
- 为了描述接受MARS治疗的患者.
- 在这个患者队列中检查脏相关事件和结果.
- 评估同时使用CKRT对死亡率和恢复的影响.
主要方法:
- 在2014年1月至2020年12月期间开始MARS治疗的49名患者的回顾性队列研究.
- 收集了关于治疗指示,肝移植,CKRT使用,恢复和死亡率的数据.
- 统计分析包括相对风险和置信区间,以比较不同组的结果.
主要成果:
- 59%的患者 (29/49) 需要同时进行CKRT.
- 肝脏脑病是MARS的主要征兆 (55%).
- 接受CKRT的患者 (41%) 的住院死亡率明显高于不需要CKRT的患者 (10%). 在CKRT组中,一年死亡率也明显高于CKRT组 (59%对25%).
- 在接受CKRT的患者中,39%的患者在出院前恢复了功能.
结论:
- 需要MARS治疗的患者经常发展AKI,需要CKRT.
- 在MARS患者中同时使用CKRT与增加住院和一年死亡率有关.
- 虽然脏恢复是可能的,但需要CKRT的MARS患者的整体预后仍然很差.
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