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在COVID-19中高凝血状态和下肢自由手术的影响:一项回顾性多中心研究
David Stark1, Susan Hendrickson1, Chaninda Dejsupa2
1North Bristol NHS Trust, Bristol, United Kingdom.
概括
之前的COVID-19感染或接种疫苗并没有显著增加下肢自由手术中的微血管并发症. 对这些患者来说,可能不需要进一步的血栓预防治疗.
科学领域:
- 血管外科 血管外科
- 血栓形成的研究研究
- 传染病流行病学 传染病流行病学
背景情况:
- 严重的COVID-19 (冠状病毒疾病2019) 和疫苗接种与大血管血栓形成有关.
- 之前的COVID-19感染 (轻度/无症状) 或接种疫苗对微血管血栓瘤在自由组织转移中的影响尚不清楚.
研究的目的:
- 为了比较COVID-19时代前后的下肢自由患者的微血管并发症率.
- 评估以前的COVID-19感染和疫苗接种对自由手术中血栓性并发症的影响.
主要方法:
- 从3个创伤中心的198个下肢自由板收集回顾性数据.
- 分析了两个6个月的时间段 (COVID前和后的时代),至少进行90天的随访.
- 修改Poisson回归用于比较COVID-19感染/接种疫苗和未感染/未接种疫苗队列之间的并发症率.
主要成果:
- 微血管并发症发生在2/10名先前感染COVID-19的患者中,而16/188 (8.5%) 没有.
- 接种疫苗的患者患有微血管并发症的比例为12%,而未接种疫苗的患者则为7%.
- 这些差异在统计学上并不显著.
结论:
- 之前的COVID-19感染或接种疫苗似乎不会显著增加下肢自由手术中的微血管并发症.
- 对于患有COVID-19病史或接种疫苗,接受自由手术的患者,可能不需要额外的血栓预防.
- 在大手术期间,外科医生应保持对全身感染对血栓栓塞风险的影响的认识.
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