儿科肝移植后的血管血栓:预防是可以实现的吗?
Mercedes Martinez1, Elise Kang1, Fernando Beltramo2
1Columbia University Irving Medical Center, Department of Pediatrics, New York, USA.
Journal of liver transplantation
|December 1, 2023
概括
张开的筋膜是儿科肝移植后血管血栓的主要危险因素. 抗凝药并没有增加出血,这表明改进的手术技术是预防这些危及生命的事件的关键.
科学领域:
- 儿科手术 儿科手术
- 移植医学 移植医学
- 血管外科 血管外科
背景情况:
- 血管血栓 (VT) 在儿科肝移植 (LT) 中具有重大危及生命的风险.
- 关于腹内静脉瘤风险因素的现有研究仅限于单一中心研究,缺乏大规模的儿科数据.
研究的目的:
- 在儿科肝移植接受者中识别腹腔内血管血栓 (VT) 的风险因素.
- 在这个患者群体中评估与抗凝血相关的出血并发症.
主要方法:
- 进行了一项多中心回顾性队列研究.
- 在孤立的儿科LT接受者中分析了手术前和手术后的变量.
主要成果:
- 9.37%的患者在术后7天内发生腹内静脉瘤.
- 张开的面膜是静脉瘤的唯一独立风险因素 (OR = 2.84,p = 0.012).
- 静脉瘤患者经历了更高的血液产品输血率,移植损失,感染和重新手术; 血液风险与抗凝药或不用抗凝药相似.
结论:
- 预防性抗凝剂没有提高儿科LT接受者的出血并发症.
- 张开的面膜,可能表明移植/受体大小不匹配,是主要的静脉瘤风险因素.
- 改进的外科手术技术对于预防静脉瘤至关重要,因为仅用抗凝剂可能无法完全预防.
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