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在中腔再血管化后,胃肠道出血的发生率和预测因素
Armin Farazdaghi1, Diego V S Rodrigues1, Claire Cassianni2
1Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN.
Journal of vascular surgery
|November 20, 2024
概括
手术后的胃肠道出血 (GIH) 是中腔再血管化后的重大风险,影响近20%的患者. 识别急性呈现和肠切除等高风险因素对于改善患者的治疗结果至关重要.
科学领域:
- 血管外科 血管外科
- 胃肠病学 胃肠病学
- 临床结果研究研究
背景情况:
- 手术后的胃肠道出血 (GIH) 是经过中腔再血管化的已知并发症.
- 然而,其发生率和特定预测因子在开放式 (OR) 和内血管 (ER) 重血管化程序中没有得到充分报告.
研究的目的:
- 为了确定中腔再血管化后临床显著GIH (CS-GIH) 的发生率.
- 确定与接受这些手术的患者中CS-GIH风险增加相关的预测因素.
主要方法:
- 一个单一中心的回顾性审查对在2009年至2019年期间接受OR或ER治疗中肠缺血的患者进行了.
- 排除标准包括非封闭性半肠缺血,早期死亡率和缺乏随访. 临床显著的GIH是由特定的输血,再接收或干预标准来定义的.
主要成果:
- 在205名符合条件的患者中,18%的患者经历了CS-GIH,21%的患者在术后30天内发生.
- 与CS-GIH显著相关的因素包括肠切除 (OR,11.29),急性呈现 (OR,5.42),心房 (OR,3.01),新的抗血小板治疗 (OR,2.61) 和支架 (OR,2.31).
结论:
- 中腔再血管化带有术后GIH的高风险,有助于增加发病率和资源利用率.
- 鉴定患有危险因素的患者,如急性呈现,需要肠切除,心房动,开始抗血小板治疗或支架,对于有针对性的术后护理来缓解CS-GIH至关重要.
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