在血动力学稳定的患者中延迟动脉动脉瘤手术:多中心回顾分析
Teiko Kawahigashi1,2, Jo Taisuke3, Taro Shimizu4
1Department of General Internal Medicine, Shonan Kamakura General Hospital, Kamakura, JPN.
Cureus
|September 4, 2025
概括
患有稳定的血压和破裂的胸腔或腹腔大动脉瘤 (TAA/ AAA) 的患者经历了更长的手术时间. 这突显了血液动力稳定的TAA/ AAA患者的潜在治疗延迟.
科学领域:
- 血管外科
- 紧急医疗
- 大动脉动脉瘤研究
背景情况:
- 破裂的胸腔或腹腔大动脉瘤 (TAA/AAA) 是危及生命的外科紧急情况.
- 及时进行手术对于改善TAA/AAA患者的存活率至关重要.
- 初始血液动力学状态对TAA/ AAA破裂的治疗时间表的影响尚未完全理解.
研究的目的:
- 在TAA/AAA破裂患者中,研究初始缩血压与手术前的时间之间的关联.
- 测试血液动力稳定的患者 (非低血压患者) 与低血压患者相比,手术延迟时间较长的假设.
主要方法:
- 在两家日本医院2010年至2021年期间入院的TAA/AAA破裂患者的回顾性研究.
- 血压稳定 (> 90 mmHg) 和低血压 (≤ 90 mmHg) 的患者之间的门到手术时间的比较.
- 用多变量线性回归分析来评估血压与手术时间之间的关系.
主要成果:
- 在94名患者中,有29. 8%的患者出现低血压.
- 与低血压患者相比,血液动力稳定的患者在手术前的时间显著更长 (152 分钟,p=0. 003).
- 多变量分析证实低血压患者的手术时间更短 (百分比差异为-26. 3%).
结论:
- 血液动力稳定的TAA/ AAA破裂患者可能面临更长的手术延迟.
- 在稳定的TAA/AAA患者中,延迟治疗可能会导致更糟糕的结果.
- 需要提高临床警,以确保所有TAA/ AAA破裂患者及时介入,无论最初的血液动力状况如何.
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