加快手术不会增加老年关节骨折患者的输血率,这些患者正在服用XA因子抑制剂
Juntian Wang1, Paal Nilssen1, Julia Stone2
1Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, CA.
OTA international : the open access journal of orthopaedic trauma
|December 28, 2023
概括
一个新的协议显著减少了老年关节骨折患者使用Xa因子抑制剂 (Xa-I) 的手术延迟. 这种加快的手术并没有增加输血或出血风险,改善了患者的护理.
科学领域:
- 老年医学 老年医学
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 患有关节骨折的老年患者在服用Xa因子抑制剂 (Xa-I) 时经常面临手术延迟.
- 现有的协议可能无法充分解决该群体中Xa-I的药理学挑战.
研究的目的:
- 评估旨在加快老年关节骨折患者外科手术时间的药理学方案对Xa-I的影响.
- 在这个患者群体中评估早期手术干预的安全性和有效性.
主要方法:
- 一级创伤中心的回顾性队列研究.
- 将68名患者 (标准组) 与96名患者 (加快组) 进行比较,这些患者在XA-I治疗期间接受了关节骨折手术.
- 分析了手术前的时间 (TTS),输血率,血液损失和90天后的并发症.
主要成果:
- 在加速组 (28.6小时) 和标准组 (44.8小时) 中,TTS的中位数显著较短 (P < .001).
- 两组之间在整体输血率,血液损失或90天并发症率方面没有发现显著差异.
- 手术的时间不是输血率的预测因素.
结论:
- 实施药理动力学协议可以安全地缩短XA-I上老年关节骨折患者手术的时间.
- 早期的外科干预是可行的,而不会增加不良结果,如出血或输血需求.
- 该协议为优化这种脆弱患者群体的护理提供了有价值的工具.
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