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吸食阿片类药物的使用模式和血液透析接入手术后持续使用.
Timothy P Copeland1, William J Nahm2, Karen Woo3
1Division of Nephrology, University of California, San Francisco, CA.
Journal of vascular surgery
|June 7, 2025
概括
血液透析接入手术的阿片类药物处方增加了长期使用阿片类药物的风险. 处方超过42片5毫克的可等效剂显著提高了这种风险,而较短的处方没有.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 在血液透析后,阿片类药物疼痛管理是常见的.
- 这些处方的长期后果尚不清楚.
研究的目的:
- 为了评估血液透析接入手术后持续使用阿片类药物的风险.
- 为了确定与持续使用相关的阿片类药物剂量和持续时间的模式.
主要方法:
- 对接受血液透析的Medicare注册,先前未服用阿片类药物的患者进行回顾性队列研究.
- 定义持续使用阿片类药物作为处方90至180天后手术.
- 使用Cox比例危险和混合效应回归模型来分析阿片类药物使用模式和风险.
主要成果:
- 超过28000名患者被纳入;50.2%的患者在创建访问时接受了阿片类药物处方.
- 处方≥42片 (2周) 的5毫克可等效剂增加了1.28倍的持续阿片类药物使用风险.
- 处方≤20片没有与持续阿片类药物使用风险的增加有关.
结论:
- 血液透析接入程序存在持续使用阿片类药物的风险.
- 建议在血液透析接入时使用保守的疼痛管理指南.
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