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与脊髓转移相比,与多发性骨髓瘤相关的脊柱干涉的手术与更高的血液损失有关吗?
Jens P Te Velde1,2,3,4, Hester Zijlstra5,6,7, Robertus J B Pierik5
1Department of Orthopedic Surgery, Massachusetts General Hospital, 55 Fruit Street, MA, 02114, Boston, USA. jens@tevelde.amsterdam.
概括
经历脊髓手术的多发性骨髓瘤 (MM) 患者的血液损失明显高于脊髓转移 (SPM) 患者. 这一发现强调了与MM脊髓病变相关的明显出血风险.
科学领域:
- 在瘤学瘤学.
- 脊柱外科手术 脊柱外科手术
- 血液学恶性瘤 血液学恶性瘤
背景情况:
- 多发性骨髓瘤 (MM) 导致脊柱骨损伤.
- 在MM脊椎手术中,出血风险的了解很少.
- 毫米脊髓病变通常与脊髓转移 (SPMs) 组合在一起.
研究的目的:
- 评估MM与SPM患者的出血指数 (BI) 和估计的血液损失 (EBL).
- 改善进行脊椎手术的MM患者的手术规划.
- 在MM和SPM脊椎病变之间区分出血风险.
主要方法:
- 追溯性倾向分数匹配的病例控制研究.
- 119名MM患者和119名SPM患者接受瘤脊椎手术.
- 使用BI和EBL通过Wilcoxon签名等级测试进行手术内出血的比较.
主要成果:
- 在MM患者中,BI (5.6比3.9,p=0.02) 和EBL (850毫升比600毫升,p=0.039) 显著更高.
- MMBI与激素依赖性乳腺癌和细胞癌相比.
- 对于MM或SPM患者,每次手术的出血风险没有显著差异.
结论:
- 与SPM患者相比,MM患者的手术内出血明显高.
- 毫米脊髓病变具有相当大的出血风险,类似于高血管性SPM.
- 这些发现需要为MM患者量身定制的手术规划.
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