宫外围注射类固醇注射后并发症的发生率和危险因素
Harsh Wadhwa1, Matthew Rohde1, Jayme C B Koltsov1
1Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA.
The spine journal : official journal of the North American Spine Society
|December 18, 2024
概括
宫外周类固醇注射 (CESI) 的并发症很少发生,但随着时间的推移而增加. 转胺疗法和抗凝剂使用等因素与更高的风险有关,需要对患者进行仔细的选择和监测.
科学领域:
- 疼痛管理 疼痛管理
- 干预性疼痛程序 干预性疼痛程序
- 神经外科 神经外科
背景情况:
- 宫外周类固醇注射 (CESI) 是宫病理的常见治疗方法.
- 虽然严重并发症很少见,但其发生率和风险因素需要进一步描述.
研究的目的:
- 为了确定在CESI后7,30和90天内发生的并发症的发生率.
- 确定与这些并发症相关的风险因素.
主要方法:
- 使用大型国家行政索赔数据库 (Meritive Marketscan) 进行回顾性队列研究.
- 包括229,412名患者从2008年到2015年接受了448,209名CESI.
- 多变量后勤回归模型分析了并发症率和风险因素,按程序和医疗并发症分层.
主要成果:
- 整体并发症率从7天后的1.7%增加到90天后的8.0%.
- 相比于跨层方法,转层式方法与在7天内出现手术 (1.55) 和神经系统 (1.69) 并发症的几率更高有关.
- 抗凝药处方 (OR 5.40) 和有静脉血栓栓塞病史 (OR 3.01) 是30天内出现并发症的重要危险因素.
结论:
- 与CESI相关的并发症很少见,神经系统并发症发生在0.5%的7天内.
- 变形膜治疗方法与程序并发症率的增加有关.
- 诸如肥胖,现有的神经系统缺陷,焦虑和抗血小板药物等因素需要注意减轻风险.
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