在前脊椎外科手术期间,暂时的手术内 iliac 动脉封闭的发生率
Matthew H Claydon1,2, Dean T Biddau1,3,2, Alexander N Claydon1
1Neuroscience Institute, Epworth Hospital, Richmond, Melbourne, Australia.
North American Spine Society journal
|October 9, 2024
概括
在前腰部手术期间,暂时阴动脉封闭 (TIAO) 是常见的,影响29%的患者. 在L4/5水平,特别是在全盘更换,显示高TIAO发病率.
科学领域:
- 血管外科 血管外科
- 脊柱外科手术 脊柱外科手术
- 血栓栓塞的并发症 血栓塞的并发症
背景情况:
- 前腰脊椎手术带有由于血栓栓塞并发症而失去肢体的罕见风险.
- 阴道血管收缩可能导致暂时阴道动脉封闭 (TIAO),阴道动脉血栓的估计发病率为0.45%.
- 在外科手术期间的肝化可能会减轻血栓栓塞的风险.
研究的目的:
- 量化前腰脊椎手术期间暂时阴动脉封闭 (TIAO) 的发生率.
- 检查TIAO与患者因素 (性别,BMI) 和手术因素 (磁盘水平,假肢类型) 的关联.
主要方法:
- 对605名接受前腰椎脊椎手术的患者 (2009-2022) 的回顾性分析.
- 程序包括全盘置换 (TDR),前腰椎间体融合 (ALIF) 或混合程序.
- 通过失去脚脉冲氧度波形和非可触摸的远端外侧阴动脉脉冲来定义的TIAO;如果发生TIAO,则服用肝素.
主要成果:
- 在605名患者中,TIAO发生在176名患者中 (29.1%).
- 与ALIF (13.5%) (p=.004) 相比,TDR中TIAO的发生率更高 (42.7%).
- L4/5水平显示TIAO率 (65.2%) 比L5/S1 (3.1%) 高得多,特别是在TDR (74.6%对比48.5%的ALIF在L4/5).
结论:
- 在前腰部暴露期间,暂时阴动脉封闭 (TIAO) 是常见的 (29%).
- 在L4/5的外科水平,特别是全盘置换,呈现TIAO的高发病率.
- 在研究队列中没有观察到术后血栓或栓塞并发症.
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