微手术乳房重建和初级高凝血性疾病.
Rakel M Zarb1, Charles Lamberton1, Aishwarya Ramamurthi1
1Department of Plastic Surgery, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA.
Microsurgery
|February 12, 2024
概括
对于患有初级高凝血性疾病的患者来说,微手术乳房重建是可行的. 扩展低分子量肝素 (LMWH) 预防是安全的,尽管板救援具有挑战性.
科学领域:
- 微手术 微手术是一种微手术.
- 整形外科 整形外科 整形外科
- 血液学 血液学 血液学
背景情况:
- 主要的高凝血性疾病在微手术中提出了挑战,传统上是对免费组织移植的禁忌.
- 自由片在乳房重建中具有优势,需要扩大患者选择标准.
- 这项研究评估了进行乳房重建的高凝血患者的化疗预防方案.
研究的目的:
- 描述一种化学预防方案,用于免费翻盖乳房重建中的初级高凝性.
- 为了比较高凝血和非高凝血患者之间的片结果和并发症.
- 在这个队列中评估扩展低分子量肝素 (LMWH) 的安全性和有效性.
主要方法:
- 对15名患有初级高凝血能力的患者 (25个片) 进行了回顾性审查,这些患者正在接受微手术乳房重建 (2010-2020年).
- 与785名没有高凝血能力的患者 (1268个片) 进行了比较,包括有静脉血栓栓塞 (VTE) 病史的患者.
- 坚持加强流行病学观察研究报告 (STROBE) 准则.
主要成果:
- 超凝血患者包括V因子莱登突变,蛋白S缺乏,原血突变和抗脂综合征.
- 没有观察到术后静脉瘤或死亡率;与对照组相比,血液瘤或输血率没有显著差异.
- 高凝血组的损失率为4%,对照组为0.92% (p=0.15);血管损伤的挽救率很低 (0%对52%).
结论:
- 在患有初级高凝血性疾病的妇女中,微手术乳房重建是可行的.
- 可接受的损失率是可以实现的,但对血管损害的挽救潜力是有限的.
- 扩展的术后LMWH预防是这个患者群体的安全方案.
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