在库辛病中经过跨形手术后出现症状的静脉血栓栓塞:发病率和危险因素
Masaaki Mikamoto1,2, Ye Rim Chang1, Hang Lee3
1Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Pituitary
|May 25, 2025
概括
库辛病患者在经脊髓外科手术 (TSS) 后面临早期静脉血栓栓塞 (VTE) 的风险更高. 积极的VTE预防对于高危人群至关重要,以预防肺栓塞等并发症.
科学领域:
- 内分泌学 在内分泌学.
- 神经外科 神经外科
- 血管外科 血管外科
背景情况:
- 库辛病 (CD) 与静脉血栓栓塞 (VTE) 的风险增加有关.
- 转形手术 (TSS) 是对垂体腺瘤的主要治疗方法,包括导致CD的腺瘤.
- 了解接受TSS的CD患者的术后VTE风险对于患者的安全至关重要.
研究的目的:
- 确定手术后VTE发生率的库辛氏病 (CD) 患者接受跨形手术 (TSS).
- 为了确定与VTE发展相关的风险因素,在TSS后的CD患者中.
- 为了比较CD患者和非功能性垂体腺瘤 (NFPAs) 患者之间的早期VTE病率.
主要方法:
- 在2005年至2019年期间接受了TSS的CD和NFPA患者的回顾性分析.
- 在TSS后90天内VTE发病率的比较,重点是早期VTE (7天内).
- 根据临床怀疑,通过成像 (超声波,CT) 确认了VTE诊断.
主要成果:
- 在6名CD患者中,有5名在TSS后7天内出现了症状的VTE,而NFPA患者则为零 (p=0.006).
- 两名CD患者在术后1-2天患有肺栓塞 (PE);两名早期深静脉血栓塞 (DVT) 患者有先前的DVT病史.
- 在单变量分析中,患有TSS后VTE的CD患者具有更高的先前VTE病史 (p=0.003),高血压 (p=0.038) 和更大的瘤大小 (p=0.045) 的比率.
结论:
- 库辛氏病患者在TSS后表现出早期VTE的风险增加,包括症状性PE.
- 建议识别高风险的CD患者,并实施术后静脉瘤预防.
- 需要进一步的研究,以优化VTE预防策略在这个特定的患者群体.
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