前左心室辅助装置内镜评估不会降低以后胃肠道出血的风险:一项多中心研究
Jiahao Peng1, Samanthika Devalaraju2, Mohamed Azab3
1Center for Health Research, Loma Linda University Health, Loma Linda, California (Jiahao Peng).
Annals of gastroenterology
|May 23, 2024
概括
在左心室辅助装置 (LVAD) 植入之前的术前内镜与胃肠道出血 (GIB) 的更高风险有关. 这项研究表明,内镜查可能不需要用于预防LVAD后GIB.
科学领域:
- 心脏病学 心脏病学
- 胃肠病学 胃肠病学
- 手术并发症 手术并发症
背景情况:
- 胃肠道出血 (GIB) 是左心室辅助器件 (LVAD) 植入后的常见并发症.
- 一些医疗中心使用手术前内镜来潜在地减少LVAD后GIB的发生率.
- 这项研究调查了手术前内镜与LVAD安置后GIB风险之间的关联.
研究的目的:
- 评估手术前内镜是否与左心室辅助器件 (LVAD) 植入后胃肠道出血 (GIB) 的风险降低有关.
- 确定术前内镜查对LVAD患者GIB发病率的影响.
主要方法:
- 一项多中心队列研究包括了398名在2010年至2019年期间接受LVAD插入的患者.
- 参与者被分为两组:接受了手术前内镜检查的人和没有接受的.
- 主要结局是LVAD后一年内GIB,次要结局包括严重出血和手术内并发症.
主要成果:
- 总共有114名患者 (28.6%) 在一年内经历了GIB.
- 在手术前内镜队列 (36.4%) 中,GIB的发病率高于没有内镜队列 (24.8%,P=0.015).
- 在对共变量进行调整后,术前内镜仍然与GIB风险增加有关 (aOR1.77,P=0.032). 动脉静脉形形和胃病是最常见的GIB来源.
结论:
- 在LVAD植入之前的术前内镜似乎与随后的GIB风险增加有关.
- 尽管控制了混因素,但研究结果表明,常规内镜查可能对预防GIB在这个患者群体中没有好处.
- 可能需要进一步的研究,以充分阐明术前干预和LVAD后并发症之间的复杂关系.
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