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在急性A型大动脉解剖的白天和夜间手术后的结果
Till Joscha Demal1,2, Tim Knochenhauer1, Jessica Weimann3
1Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany.
概括
进行A型大动脉剖析的夜间手术与白天手术一样安全,不增加死亡或重新手术的风险. 这一发现支持夜间手术对这种疾病的安全执行.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 大动脉疾病管理管理
背景情况:
- 甲型大动脉解剖是一种危及生命的疾病,需要迅速的手术干预.
- 对A型大动脉解剖进行手术的最佳时间 (白天与夜间) 仍然是争论的主题.
- 欧洲A型大动脉剖析注册表 (ERTAAD) 数据库为比较结果分析提供了大量队列.
研究的目的:
- 为了比较白天和夜间A型大动脉剖析手术的早期和晚期结果.
- 评估手术时间对死亡率,再手术率和二次并发症的影响.
- 为了确定夜间手术是否与A型大动脉解剖患者的不良结果有关.
主要方法:
- 对来自18个欧洲中心的3902名患者 (2005-2021) 进行了回顾性分析,这些患者接受了A型大动脉解剖手术.
- 患者被分为白天 (8点至8点) 和夜间 (8点至8点) 的手术组.
- 倾向性得分匹配用于比较结果,包括全因死亡率,重新手术率,心肌梗塞,神经结果和功能衰竭.
主要成果:
- 在匹配了1475对后,没有观察到外科手术技术的差异.
- 白天手术与全球脑损伤的发病率较高 (5.4%对3.6%) 有关.
- 日间组的1年 (24.8%对21.7%) 和10年 (48.7%对45.1%) 死亡率明显较高,在10年后的重新手术率没有差异.
结论:
- 针对A型大动脉解剖的夜间手术与短期或长期不良结果无关.
- 这些发现表明,手术时间不会影响患者的治疗结果.
- 对于A型大动脉剖析的夜间手术可以安全地进行.
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