在VQI中,在外周血管干预过程中使用质氨酸
Sahar Ali1, Fatma M Shebl2, Edouard Aboian3
1Vascular Surgery Department, Assiut University Hospital, Faculty of Medicine, Assiut, Egypt.
Annals of vascular surgery
|December 18, 2023
概括
在外周血管干预 (PVIs) 中使用前列素减少了出血,但增加了心脏并发症. 建议对高风险患者进行选择性治疗.
科学领域:
- 心血管医学 心血管医学
- 血管外科 血管外科
- 麻醉学 麻醉学
背景情况:
- 质氨酸在动脉手术中减少出血,但其在外周血管干预 (PVIs) 中的作用尚不清楚.
- 这项研究调查了血管质量倡议 (VQI) 内的蛋白质胺利用趋势和PVI的结果.
研究的目的:
- 为了评估蛋白质胺类药物和PVIs后的外科手术期间出血之间的关联.
- 评估蛋白质胺对其他术后结果的影响,包括心脏并发症和死亡率.
主要方法:
- 在2016-2020年VQI数据库中对选择性PVI患者的分析.
- 倾向性得分匹配被用来比较接受前胺和不接受前胺的患者之间的结果.
- 多变量波桑回归估计为外科手术期间的结果调整的利率比率.
主要成果:
- 在研究期间,蛋白质胺使用量从5.2%增加到22.9%.
- 经过倾向匹配后,蛋白质胺的使用与出血显著减少有关 (aRR,0.89).
- 蛋白质胺使用与心脏并发症增加相关 (aRR,1.27) 但死亡率并非如此. 它还与较少的远端栓塞,但更多的穿孔有关.
结论:
- 在PVI中使用原氨酸与减少外科手术期间出血有关.
- 然而,蛋白胺使用也与心脏并发症风险增加有关.
- 在患有高出血风险的PVI患者中,建议选择性地给予前胺.
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