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优化中枢静脉接入器件在血栓缩患者中的插入:平衡疗效和安全性
Hossein Farsavian1, Mahdi Davoodi1, Mohammad Javad Najafi2
1Department of Surgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
The journal of vascular access
|August 26, 2024
概括
中枢静脉接入装置 (CVAD) 插入在血栓塞车患者中是安全的,即使血小板数量较低. 超声指导将并发症降至最低,支持CVAD安置的较低门,并减少输血.
科学领域:
- 医疗器械 医疗器械
- 血管接入 血管接入
- 血液学 血液学 血液学
背景情况:
- 危急疾病的发病率不断上升,需要使用中央静脉接入装置 (CVAD).
- 在患有血小板缺血的患者中插入CVAD存在重大挑战.
- 目前的指导方针通常要求高血小板计数,以确保安全的CVAD安置.
研究的目的:
- 评估CVAD插入的安全性和风险在血小板缺血患者.
- 为高风险个体的CVAD程序提供临床实践的信息.
- 评估使用较低血小板计数值用于CVAD插入的可行性.
主要方法:
- 预期队列研究 (2020年9月 - 2023年9月).
- 包括18至80岁的患者,血小板计数<50,000/dL.
- 通过Seldinger技术利用超声波引导的CVAD插入.
主要成果:
- 137名参与者 (54%是男性,平均年龄为46.9岁).
- 根据CVAD部位 (关骨与大腿骨) 的出血没有显著差异.
- 股骨导管显示感染率较高;没有观察到输血并发症或死亡率.
结论:
- 在血小板缺血患者中,CVAD插入是安全的,包括那些数量小于10 × 10 ^ 9 / L的患者.
- 经验丰富的外科医生的超声指导是最小化并发症的关键.
- 这些发现支持修订目前针对较低血小板计数值的指导方针,减少输血需求.
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