在下降胸腔和腹腔大动脉动脉瘤的开放手术中进行手术内输血的性别差异:一项回顾性单中心队列研究
Jianfeng Gao1, Ruxuan Wang1, Fangda Li1
1Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
BMC surgery
|July 18, 2025
概括
由于下降胸腔和腹腔大动脉动脉瘤 (DTAA) 而接受开放性手术修复的妇女对手术内红细胞 (RBC) 输血的需求明显更高. 这些发现强调了针对女性患者量身定制的输血策略的重要性.
科学领域:
- 血管外科 血管外科
- 输血医学 输血医学
- 患者的治疗结果.
背景情况:
- 在大动脉动脉瘤修复结果中存在性别差异.
- 内科手术输血率和下降胸腔和腹腔大动脉动脉瘤 (DTAA) 开放手术修复 (OSR) 的预测因素尚未确定.
研究的目的:
- 调查DTAA的OSR期间手术内红细胞 (RBC) 输血率的基于性别的差异.
- 在接受DTAA的OSR患者中确定手术内输血的预测因子.
主要方法:
- 对82名接受DTAA的OSR患者的回顾性分析.
- 用于识别输血预测因子的物流回归模型.
- 进行了调整分析,以评估女性性别与红细胞输血之间的关联.
主要成果:
- 女性患者的手术内红血球输血率显著更高 (82.6%与45.8%相比).
- 女性性别,胸腔腹腔动脉瘤,更长的手术持续时间和更大的血液损失与输血增加有关.
- 女性性别是输血的独立预测因素 (OR,5.24;P=0.034).
- 66岁以上的年龄和手术持续时间超过245分钟预测了女性的输血.
结论:
- 经过OSR的DTAA妇女显示出更高的需要进行手术内红细胞输血.
- 对于接受选择性DTAAOSR的女性,建议制定全面的红血细胞准备计划.
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