怀孕期间结血外出:手术与保守治疗对比
Yuliia Medkova1, Inna Tulina1, Ivan Novikov2
1Clinic of Colorectal and Minimally Invasive Surgery, Sechenov First Moscow State Medical University, Moscow, Russia.
Updates in surgery
|December 27, 2023
概括
孕妇患有血栓外出 (TEH) 的保守和手术治疗方法是安全有效的. 手术提供更快的疼痛缓解,而局部切除是优于血栓切除术,由于较低的再血栓形成风险.
科学领域:
- 产科和妇科 产科和妇科
- 结肠直肠手术 结肠直肠手术
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 由于胎儿安全问题,怀孕期间的血栓外出 (TEH) 管理存在挑战.
- 对于孕妇急性TEH的保守与手术干预的有限的比较数据存在.
研究的目的:
- 为了比较孕妇急性TEH的保守治疗与手术治疗的疗效和安全性.
- 评估和比较两个手术方法的结果:局部切除 (LE) 和血栓切除 (TE).
主要方法:
- 一项前性观察性研究,对手术治疗进行随机分分析.
- 主要结局包括疼痛 (VAS),患者评估 (CPGAS) 和生活质量 (SF-12).
- 在一个随机的手术小组中,LE与TE的比较.
主要成果:
- 保守治疗和手术治疗都改善了VAS,CPGAS和SF-12分数.
- 手术在SF-12的身体和精神组成部分和CPGAS在第10天显示出明显更好的结果.
- 手术在第3天早些时候提供了显著的疼痛减轻.
- 由于TE (38%) 与LE (7%) 的再血栓形成率较高,因此停止了手术比较的随机化.
- 没有报告母亲或胎儿的并发症.
结论:
- 怀孕期间急性TEH的保守和手术治疗都是安全有效的.
- 与保守措施相比,手术干预可以更快地缓解疼痛,改善生活质量.
- 局部切除是怀孕期间TEH的更安全的外科选择,而不是血栓切除,因为再次血栓形成的风险显著降低.
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