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持久性血小板缺血症表明,复杂的内血管动脉瘤修复后的内皮损伤
Annelise Long1, Sara L Zettervall2, Matthew P Sweet2
1University of Washington School of Medicine, Seattle, WA, USA.
在 fenestrated-branched 内血管动脉瘤修复 (F-BEVAR) 后持续的低血小板计数可能表明高压内泄漏. 考虑对F-BEVAR患者进行主动脉成像,这些患者在术后的第四天血小板数量较低.
科学领域:
- 血管外科 血管外科
- 血管内修复 血管内修复
- 大动脉动脉瘤治疗方法
背景情况:
- 经 fenestrated-branched 内血管动脉瘤修复 (F-BEVAR) 后的高压内泄漏 (I型和III型) 会增加破裂的风险.
- 早期发现这些内脏漏洞对于及时重新干预至关重要.
研究的目的:
- 调查F-BEVAR后的早期术后期持续性血小板缺血和高压内泄漏之间的相关性.
主要方法:
- 在医生赞助的试验性设备豁免研究中对接受F-BEVAR的患者进行评估.
- 根据早期术后CT扫描,将内膜泄漏分类为高压 (I或III型) 或低压 (II型).
- 统计分析以确定血小板缺血 (血小板数<100,000/μL) 与内泄存在的关联.
主要成果:
- 14%的患者患有高压内泄,16%患有低压内泄.
- 与其他组相比,患有高压内分泌泄漏的患者在术后1日至4天的血小板数量显著降低.
- 在术后4天,患有高压内泄漏的患者平均血小板<100,000/μL的可能性超过12倍.
结论:
- 经历高压内泄症的F-BEVAR患者的术后血小板数显著减少.
- 建议在术后4天血小板计数<100,000/μL的患者进行大动脉成像,因为35%的患者可能具有需要干预的高压内泄漏.
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