身体质量指数对最少侵入性大动脉程序初始阶段的影响
Elias Ewais1, Nadja Bauer2, Markus Schlömicher1
1Klinik für Herz- und Thoraxchirurgie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Nordrhein-Westfalen, Germany.
The Thoracic and cardiovascular surgeon
|December 10, 2024
概括
肥胖不会影响经过微创手术大动脉置换 (MIS-AVR) 后的结果. 尽管手术时间较长,肥胖患者的出血风险增加,但体重指数 (BMI) 没有影响死亡率或中风率.
科学领域:
- 心血管外科心血管外科
- 最少侵入性的手术
- 肥胖医学 肥胖医学
背景情况:
- 在肥胖患者中,微创手术大动脉置换 (MIS-AVR) 提出了独特的挑战.
- 肥胖与患者假肢不匹配 (PPM) 的风险增加有关.
- 本研究研究了身体质量指数 (BMI) 在MIS-AVR计划的初始阶段对结果的影响.
研究的目的:
- 为了评估BMI对MIS-AVR患者结局的影响.
- 评估肥胖与死亡率,中风,出血和PPM等并发症之间的关系.
- 为了确定BMI是否影响早期MIS-AVR计划的成功.
主要方法:
- 从2013年1月至2015年12月接受MIS-AVR的307名患者的回顾性分析.
- 患者被分为正常/超重 (BMI <30 kg/m2) 和肥胖 (BMI ≥30 kg/m2) 的两组.
- 主要终点包括30天和2年死亡率和中风;次要终点包括出血,PPM,准膜泄漏,伤口愈合障碍和节拍器率.
主要成果:
- 肥胖患者 (BMI ≥30 kg/m2) 的大动脉紧,心肺绕道和通风时间较长.
- 肥胖患者患有更高的出血风险 (9.5%对2.6%),但心脏起器率较低 (3%对9%).
- 在BMI组之间的30天或2年死亡率,中风率,PPM或膜漏水之间没有发现显著差异.
结论:
- 在MIS-AVR的初始阶段,30天死亡率可能会升高.
- 尽管手术时间较长和出血风险增加,但BMI并没有显著影响MIS-AVR患者的术后发病率,死亡率或中风率.
- 在肥胖患者中,MIS-AVR似乎是可行的和安全的,结果与非肥胖个体相似.
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