[手术前的凝血表是否会改变腺切除术后的术后出血率?]
Georges Joseph1, Carina Georgi1, Peter Kress1
1HNO / Kopf & Halschirurgie, Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier, Germany.
Laryngo- rhino- otologie
|December 22, 2023
概括
标准化凝血问卷 (GB) 并没有降低经过腺切除术 (AT) 的儿童的术后出血率. 虽然GB确定了潜在的出血障碍,但其在预防AT后并发症的有效性需要进一步调查.
科学领域:
- 儿科手术 儿科手术
- 麻醉学 麻醉学
- 血液学 血液学 血液学
背景情况:
- 腺切除术 (AT) 是一种常见的儿童手术,存在危及生命的术后出血的风险.
- 2006年德国的一项指导方针建议使用标准化凝血问卷 (GB) 而不是常规血液测试来预手术选出出血障碍 (GS).
- 该指南旨在预防儿童在AT后出现的出血并发症.
研究的目的:
- 评估标准化凝血问卷 (GB) 在降低腺切除术 (AT) 和再腺切除术 (Re-AT) 后术后出血率方面的有效性.
- 为了比较2014年GB实施之前和之后接受AT/Re-AT的儿童的出血率.
主要方法:
- 一项单中心,非随机,回顾性研究分析了2633名1至6岁儿童的数据.
- 该研究比较了在2011-2014年 (没有GB) 和2014-2018年初 (有GB) 期间接受AT/Re-AT的儿童的出血率.
主要成果:
- 没有GB的出血率为0.83%,随着GB的使用增加到2.08%.
- 在174个不正常的GB结果中,进行了169个凝血诊断 (GD),在很小的百分比中证实了罕见的出血障碍.
- 在检测出血乱时,GB的灵敏度为16%,特异性为87.5%.
结论:
- 标准化凝血问卷 (GB) 可以在接受腺切除术的儿科患者中识别潜在的凝血障碍 (GS).
- 然而,GB没有被发现是有效的降低整体的术后出血率在腺切除术后.
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