经过横向胸切除术的肺移植后与胸并发症相关的危险因素
Joshua T Kim1, Yudai Miyashita1, Taisuke Kaiho1
1Division of Thoracic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Journal of thoracic disease
|October 29, 2025
概括
肺移植后的部伤口并发症与男性性别和急性损伤有关. 女性患者的风险较低,而术后功能衰竭增加了风险,需要采取预防措施.
科学领域:
- 胸部外科手术 胸部外科手术
- 移植医学 移植医学
- 伤口愈合研究研究研究
背景情况:
- 胸部伤口脱光和感染是肺移植后的重大并发症,影响患者的治疗结果.
- 这些并发症与死亡率增加,住院时间延长和移植功能受损有关.
- 有限的当代数据存在于患者和手术相关的风险因素,用于肺移植接受者的胸部并发症.
研究的目的:
- 识别骨脱落和感染的独立手术前和手术后预测因素.
- 在现代肺移植实践的背景下分析风险因素.
主要方法:
- 在2018年至2024年间,对290名肺移植患者进行了骨切除术的回顾性审查.
- 一组33名患有胸部并发症的患者与257名没有并发症的患者进行了比较.
- 用单变量和多变量逻辑回归分析患者人口统计学,术前条件,手术因素和术后结果.
主要成果:
- 骨脱落/感染的发生率为11.4%,中位数的重新操作间隔为99天.
- 单变量分析表明男性的风险更高,术后急性损伤 (AKI) 和静脉静脉外体膜氧化 (ECMO) 使用.
- 多变量分析显示,女性性别作为保护性 (OR=0.39) 和AKI作为显著的风险因素 (OR=2.67).
结论:
- 肺移植后的胸部并发症与男性性别和术后功能衰竭 (AKI) 有关.
- 女性患者表现出降低了胸部并发症的风险.
- 识别患有这些风险因素的患者对于实施有针对性的策略至关重要,以预防胸部并发症并改善愈合.
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