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透皮利切除术出血风险的预测因素

U Phun Loo1, Chun Hou Yong1, Guan Chou Teh1

  • 1Urology Department, Sarawak General Hospital, Kuching, Malaysia.

Asian journal of urology
|February 5, 2024
PubMed
概括

鉴定了皮肤穿神经切除术 (PCNL) 期间出血的预测因素. 没有高血压,特定的刺穿部位和更长的手术持续时间与更大的血液损失有关,尽管影响很小.

科学领域:

  • 泌尿器科 泌尿器科 泌尿器科 泌尿器科
  • 腎臟病學 (nephrology) 是一種醫學專業.
  • 手术风险评估手术风险评估

背景情况:

  • 穿皮瘤切除术 (PCNL) 是治疗结石的关键手术.
  • 在PCNL中最大限度地降低出血风险对于患者的安全和结果至关重要.
  • 识别预测因素可以改善PCNL程序的风险分层.

研究的目的:

  • 为了确定预测皮肤透神经切除术 (PCNL) 期间出血风险的因素.
  • 为了实现更好的风险分层和早期识别PCNL高风险患者.

主要方法:

  • 对接受PCNL治疗放射性不透明结石的成年患者进行前性观察研究.
  • 排除标准包括凝血病和计划的额外手术.
  • 逐步的多变量回归分析被用来评估诸如并发症,BMI,石头负担,穿孔部位,通道大小,手术位置,外科医生的资历和血红蛋白缺乏的持续时间等因素.

主要成果:

  • 4.86%的患者需要输血红细胞.
  • 没有高血压 (p=0.024),穿刺部位 (p=0.027) 和手术持续时间 (p=0.023) 与估计较高的血红蛋白缺乏发现了显著的关联.
  • 效应大小小,其他研究的因素与血红蛋白差异无关.
关键词:
流血 出血 流血 出血失血是因为失去血液.通过皮肤进行神经质切除术.预测因素是一个预测因素.风险因素 风险因素 风险因素

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结论:

  • 高血压,穿刺部位和手术持续时间显著影响PCNL估计的血红蛋白缺乏,但影响规模很小.
  • 手术位置,穿孔数和通道扩张大小与失血无关.
  • 细致的手术技术仍然至关重要;PCNL可以在被选中的患者身上安全地由学员进行.