手术前阿片类药物使用对肺移植患者的影响:一项回顾性研究
Austin Chang1, Taisuke Kaiho1, Benjamin L Thomae1
1Thoracic Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA.
Cureus
|September 22, 2025
概括
肺移植接受者手术前使用阿片类药物与增加初级移植功能障碍 (PGD) 和更长的住院时间有关,尽管没有影响生存率. 在移植前断阿片类药物可能会改善结果.
科学领域:
- 移植手术 移植手术
- 肺部病理学 肺部病理学
- 麻醉学 麻醉学
背景情况:
- 在肺移植候选人中,术前使用阿片类药物很常见.
- 手术前阿片类药物处方对肺移植结果的影响尚不清楚.
研究的目的:
- 调查术前阿片类药物使用与肺移植结果之间的关联.
- 为了确定肺移植患者与阿片类药物处方的死亡率和并发症的风险因素.
主要方法:
- 一个单一机构的肺移植数据库 (2018-2024) 的回顾性分析.
- 片剂量被正常化为吗啡等价剂 (ME).
- 统计分析包括千平方,ANOVA,克鲁斯卡尔-瓦利斯,卡普兰-梅尔和威尔科克森签名等级测试.
主要成果:
- 在399名接受者中,47.1%在移植前使用了阿片类药物 (高ME:115;低ME:73).
- 在不同组 (高ME,低ME,没有ME) 中没有观察到一年生存时间的显著差异.
- 高ME组经历了更长的ICU和住院时间,以及较高的初级移植功能障碍 (PGD) 和PGD 3级的发病率.
结论:
- 手术前使用阿片类药物,特别是高ME,是移植后PGD的独立风险因素.
- 阿片类药物使用预测了长时间住院和潜在的增加通风使用.
- 在肺移植之前断奶阿片类药物可能会减轻长时间住院并改善结果.
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