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形创伤性大动脉损伤用内血管大动脉修复治疗:年龄是否影响结果?
Maximilian Lutz1, David Wippel2, Alexander Loizides1
1Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Journal of clinical medicine
|February 13, 2025
概括
患有形创伤性大动脉损伤 (BTAI) 的老年患者的ASA分数较高,但在胸内血管大动脉修复 (TEVAR) 后的结果相似. 年龄和受伤前状态可能不会显著影响BTAI的TEVAR结果.
科学领域:
- 心血管外科心血管外科
- 创伤外科 手术 创伤外科
- 血管外科 血管外科
背景情况:
- 形创伤性大动脉损伤 (BTAI) 是创伤后死亡的重要原因.
- 胸内血管大动脉修复 (TEVAR) 是BTAI的一种治疗选择.
- 在接受TEVAR的BTAI患者中评估与年龄相关的结果至关重要.
研究的目的:
- 为了研究TEVAR治疗BTAI后患者结局的年龄相关差异.
- 评估使用TEVAR治疗的BTAI患者年龄对发病率和死亡率的影响.
主要方法:
- 在欧洲第三级护理中心 (2005-2023) 用TEVAR治疗BTAI的70名患者的回顾性分析.
- 数据收集包括临床和成像信息.
- 患者被分为不同的年龄组:<18,18-40,41-65岁和>65岁.
主要成果:
- 年龄较大的患者在美国麻醉学会 (ASA) 的得分较高 (p < 0.001).
- 在所有年龄组中,血红蛋白水平随着时间的推移而下降 (p值从0.018到<0.001).
- 伤害严重性得分 (ISS) 与重症监护室停留相关 (r = 0.594,p < 0.001);在年龄组之间没有观察到并发症或死亡率的显著差异. 住院死亡率为6% (没有与大动脉有关的).
结论:
- 尽管老年患者的ASA得分较差,但BTAI的TEVAR在各年龄组的术后发病率和死亡率都相当.
- 患者的年龄和受伤前的身体状况可能不是BTAI中TEVAR结果的重要决定因素.
- 需要进一步的研究,因为随访损失率很高 (59%).
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