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腹腔外科和静脉血栓栓塞的长期风险:基于人口的队列研究
Laura B Harrington1,2,3, Luke Benz4, Sebastien Haneuse4
1Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave., Ste. 1600, Seattle, WA, 98101, USA. Laura.B.Harrington@kp.org.
Obesity surgery
|April 30, 2024
概括
腹腔外科手术增加了短期静脉血栓栓塞 (VTE) 的风险,但显著降低了长期VTE和肺栓塞 (PE) 的风险. 这项研究阐明了减肥手术后不断变化的VTE风险.
科学领域:
- 心血管健康 心血管健康
- 外科手术的结果
- 肥胖医学 肥胖医学
背景情况:
- 减肥手术是严重肥胖的常见干预措施.
- 短期静脉血栓塞栓症 (VTE) 的风险是被认可的腹腔外科手术后.
- 减肥手术后的长期VTE风险仍然不太了解.
研究的目的:
- 评估腹手术后静脉血栓栓塞 (VTE) 的长期风险.
- 为了比较长期的VTE和肺栓塞 (PE) 风险,减肥手术患者和匹配的对照.
主要方法:
- 基于人口的回顾性匹配队列研究.
- 包括接受减肥手术的成年人 (BMI ≥35 kg/m2) (n=30,171) 与匹配的非手术对照 (n=218,961).
- 对于发生的VTE事件,随访时间延长至10.7年.
主要成果:
- 在短期 (30天) 的手术后,减肥手术显示VTE风险增加了5倍 (aHR=5.01) 和PE风险增加了近4倍 (aHR=3.93).
- 长期 (1年),减肥手术与48%较低的VTE风险 (aHR=0.52) 和70%较低的PE风险 (aHR=0.30) 相关.
- 在5年后,这些好处仍然存在,减肥手术与VTE风险降低41% (aHR=0.59) 和PE风险降低55% (aHR=0.45) 相关.
结论:
- 腹腔外科手术与短期内暂时增加的静脉瘤风险有关.
- 从长远来看,减肥手术与VTE和PE风险大幅降低有关.
- 这些发现突出显示,在低血压手术后,VTE风险概况发生了显著的变化.
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