腹腔大动脉移植感染的外科治疗:网络元分析
Hongxin Shu1, Xuhui Wang2, Menghui Wang1
1Department of Neurosurgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
BJS open
|January 29, 2024
概括
在现场修复的部分移植切除为腹腔大动脉移植感染的死亡率降低. 这种方法可能是选择患者的可行的治疗选择,改善生存率.
科学领域:
- 血管外科 血管外科
- 传染性疾病 传染性疾病
- 手术结果研究研究.
背景情况:
- 对腹腔大动脉移植感染的最佳管理策略尚不清楚.
- 关于不同手术干预的比较有效性的证据有限.
研究的目的:
- 评估对大动脉移植感染的各种手术选择的短期和长期结果.
- 为了比较不同治疗方式的死亡率,移植通透率和再感染率.
主要方法:
- 在Medline,Embase和Cochrane图书馆进行了系统的文献搜索.
- 一个频率网络的元分析包括22项研究,涉及1118名患者,比较了四组:完全/部分移植移除与局部/外解剖修复.
- 结果包括30天,1年和更长期的死亡率,初级通病率和再感染.
主要成果:
- 在现场修复的部分移植切除显示了最低的30天 (0%) 和1年 (6.1%) 死亡率.
- 与外解剖修复相比,在现场修复的完整移植切除显示了较低的长期死亡率 (3年:32.1%,5年:45.6%).
- 完整的移植移除与现场修复具有最低的再感染率 (8%),其次是部分移植移除与现场修复 (9.3%).
结论:
- 与完全切除策略相比,在现场修复的部分移植切除与短期死亡率显著降低有关.
- 这种技术可能代表一项可行和有效的治疗特定情况下的大动脉移植感染.
- 在现场修复,特别是部分切除,似乎有利于减少大动脉移植感染中的死亡率和再感染.
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