通过皮肤进行瘤切除后的药理性血栓预防的安全性和有效性:一项回顾性队列研究
Behnam Shakiba1, Nasim Torabi2, Robab Maghsoudi1
1Department of Urology, School of Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
World journal of urology
|September 2, 2025
概括
穿皮瘤切除术 (PCNL) 后未分离的肝素在高危患者中似乎可以预防静脉血栓塞栓症 (VTE). 虽然没有明确证明,但肝素可以减少静脉突发症,而不会增加出血并发症.
科学领域:
- 肝脏病学
- 血管外科
- 药理学
背景情况:
- 穿皮瘤切除术 (PCNL) 是大型结石的标准手术,但存在出血和静脉血栓栓塞 (VTE) 的风险.
- 由于出血问题和证据有限,目前的指导方针通常不建议药理性血栓预防.
- 本研究研究中等至高风险PCNL患者的静脉瘤预防.
研究的目的:
- 对接受PCNL的患者进行静脉瘤预防的未分离肝素的安全性和有效性进行评估.
- 在接受肝素治疗的患者和早期出院治疗的患者之间比较出血并发症和血栓塞栓事件.
主要方法:
- 在202名接受PCNL治疗的患者中进行了回顾性队列研究.
- 患者被分为两组:未分离的肝素预防 (n=79) 和没有药物预防的早期出行 (n=123).
- 结果包括出血,输血,并发症和血栓塞栓事件.
主要成果:
- 接受氨酸治疗的患者年龄较大,BMI较高.
- 在石块大小,手术持续时间,血红蛋白下降,输血率或整体并发症方面没有发现显著差异.
- 血栓塞栓事件是罕见的,并且在各组之间没有显著差异;然而,早期出行组有三次静脉动脉突发事件,其中包括一次死亡事件.
结论:
- 在PCNL后的非分离肝素血栓预防似乎是安全的,没有增加出血风险.
- 研究结果表明,在中度至高风险患者中,有潜在的降低血栓栓事件的益处.
- 最终的结论受到追溯设计和样本大小的限制.
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