非手术干预措施,以预防逆侧组织损失和截肢,在患有主要主要下肢截肢的失血管患者
Jonathan De Siqueira1,2, David A Russell2,3, Heidi J Siddle4
1Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
The Cochrane database of systematic reviews
|August 28, 2024
概括
由于证据有限,预防异侧肢截肢在患有血管障碍的患者中仍然是一个挑战. 一项研究表明,电刺激可以减少主要的截肢,但需要更多的研究.
科学领域:
- 这是血管外科手术.
- 再生医学是一种再生医学.
- 临床试验中的临床试验.
背景情况:
- 主要下肢截肢 (LLA) 往往是由于血管障碍造成的,而对侧截肢的风险很大.
- 截肢导致残疾增加,工作回归减少,以及心理负担.
研究的目的:
- 评估非手术干预措施,以防止在患有主要LLA的异动血管患者中进行对侧肢组织损失和截肢.
主要方法:
- 进行了随机对照试验 (RCT) 和准RCT的系统审查.
- 搜索包括主要数据库和临床试验注册表,截至2023年3月.
- 结果侧重于组织损失,截肢发生率/时间,生存率,生活质量和不良事件.
主要成果:
- 只有一个符合条件的RCT被确定,比较电刺激与标准康复.
- 没有报告新的组织损失;电刺激显示大额外截肢可能减少三倍 (RR 0.33,95% CI 0.04至2.99).
- 证据的确定性非常低,这是由于单一的研究具有高偏差风险.
结论:
- 没有足够的高质量的证据来指导在失血管患者中预防逆侧截肢的预防.
- 在未来的研究中,必须优先考虑对侧肢的结果.
- 这仍然是一个关键的研究重点,等待更好的证据.
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