血小板电平图的变化与细胞减小手术后的术后并发症有关
Noam Goder1, Lilach Zac2,3, Nadav Nevo1
1Department of Surgery B, Peritoneal Surface Malignancy and Melanoma Unit, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.
Pleura and peritoneum
|November 15, 2024
概括
细胞还原性手术 (CRS) 后的血小板图 (TEG) 值的变化与严重的术后并发症 (SPC) 有关. TEG可能有助于预测和管理CRS期间和之后的患者风险和高温腹腔内化疗 (HIPEC).
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 麻醉学 麻醉学
背景情况:
- 细胞还原性手术 (CRS) 与高热性腹腔内化疗 (HIPEC) 结合,是腹腔表面恶性瘤的关键治疗方法.
- 高的外科病率和严重的术后并发症 (SPC) 的有限预测仍然是重大挑战.
- 血小板电平图 (TEG) 是血静的粘性弹性测量仪,但其在预测CRS后SPC中的实用性尚未得到充分证实.
研究的目的:
- 为了研究血小板电平图 (TEG) 值在细胞减小手术 (CRS) 后的变化与严重术后并发症 (SPC) 的发生之间的关联.
- 为了确定手术内TEG参数是否可以作为SPC的预测标记在接受CRS和高热性腹腔内化疗 (HIPEC) 的患者中.
主要方法:
- 对37名接受CRS和HIPEC治疗的患者队列的回顾性分析.
- 在CRS之前和之后获得了TEG测量.
- 包括SPC在内的临床和术后数据从前性维护的数据库中收集.
主要成果:
- 与没有SPC的患者相比,经历SPC的患者在TEG上显著增加了R时间和K时间 (分别为p=0.01和p=0.03).
- 多变量分析表明,TEG值与SPC有显著的关联 (几率比=1.53,p=0.05).
- 在患者人口统计学,瘤组织学,手术程度或手术前化疗之间的SPC和无SPC组之间没有发现显著差异.
结论:
- 在CRS之后的TEG参数变化与严重的术后并发症的发展有显著的关联.
- 术内TEG监测可以为预测SPC提供有价值的见解.
- 这些发现表明,TEG可以指导手术期间的决策和手术后的患者管理,包括对适当的护理水平进行分拣.
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