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在COVID-19感染后的宫脊椎手术:什么时候可以安全地进行?
Justin P Chan1, Henry Hoang, Hao-Hua Wu
1Department of Orthopaedic Surgery, University of California Irvine, Orange, CA.
Clinical spine surgery
|April 22, 2024
概括
在COVID-19感染后至少推迟两周的脊柱手术可以降低静脉血栓栓塞事件,败血症和死亡的风险. 推迟手术超过两周通常是安全的,除了后部接近病例的30天死亡率.
科学领域:
- 神经外科 神经外科
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 已知COVID-19对各种器官系统的影响,但其对脊柱手术后外科手术后并发症的影响尚不清楚.
- 在COVID-19感染后,最佳的外科手术时间尚未确立.
研究的目的:
- 描述COVID-19感染后不同时间间隔接受脊柱手术的患者的风险概况.
- 为了确定在COVID-19诊断后进行脊柱手术的最佳时间.
主要方法:
- 对接受椎手术的患者的回顾性分析.
- 使用了国家COVID队列协作 (N3C) 数据库.
- 根据COVID-19后的手术时间分为三组的分层患者:0-2周,2-6周和6-12周.
主要成果:
- 在COVID-19诊断后2周内进行手术显著增加了静脉血栓栓塞事件,败血症和前后两种方法的30天/1年死亡率的风险.
- 在感染后2-6周内,在后部接近手术中,30天死亡风险持续升高.
- 在COVID-19感染6-12周后进行的手术中没有观察到显著增加的并发症率.
结论:
- 在COVID-19诊断后2周内进行宫脊椎手术与术后风险增加有关.
- 术后并发症的风险通常不会持续超过2周,除了后部接近手术中的30天死亡率.
- 建议在COVID-19后至少推迟2周的非紧急脊柱手术;应告知患者紧急手术的风险.
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