旋转血小板测量作为一种诊断工具,用于持续感染在两阶段交换关节塑形术
Andreas G Tsantes1,2, Dimitrios V Papadopoulos3, Stavros Goumenos4
1Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Journal of clinical medicine
|April 13, 2024
概括
旋转性血栓收缩仪 (ROTEM) 在两阶段交换关节整形术中在重新植入之前检测持续的周围假肢关节感染 (PJIs) 是有前途的. FIBTEM最大凝块牢固度 (MCF) 显示出高精度,可能指导修复手术的最佳时间.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 生物标志物发现发现
- 凝血分析 凝血分析
背景情况:
- 周围假肢关节感染 (PJIs) 在骨科手术中构成了重大挑战.
- 双阶段交换关节整形术是慢性PJI的常见治疗方法.
- 缺乏可靠的生物标志物来确认在重新植入之前的感染根除.
研究的目的:
- 为了评估旋转血小板造影仪 (ROTEM) 对于持久感染的诊断准确性.
- 评估ROTEM在指导PJI两阶段交换关节整形术中重新植入时间方面的实用性.
主要方法:
- 对70名为PJI进行两阶段交换关节整形手术的患者进行了试点回顾性分析.
- 患者根据在重新植入之前的持续感染状态 (2018年ICM标准) 进行分类.
- 传统凝血生物标志物和ROTEM参数在组之间进行比较.
主要成果:
- 较高的FIBTEM最大凝块坚定度 (MCF) 值与持久感染相关 (OR 1.30).
- 对于持久性感染,FIBTEM MCF表现出最高的诊断准确性 (AUC 0.907).
- 一个FIBTEMMCF切线≥18毫米显示了100%的灵敏度和73.4%的特异性.
结论:
- ROTEM参数,特别是FIBTEM MCF,显示出在重新植入之前识别持久感染的潜力.
- 这些凝血生物标志物可以帮助确定第二阶段手术的最佳时间.
- 需要进一步的大规模研究来验证ROTEM对持续性PJI的诊断准确性.
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