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在体外生命支持后与管相关的伤口并发症:荷兰重症监护病房的回顾性队列研究

Ineke van de Pol^1,2, Margreet van Rees¹, Gwen van Gool¹

¹Department of Intensive Care, St. Antonius Hospital, Nieuwegein, The Netherlands.

|December 22, 2025

概括

与管相关的伤口并发症 (CRWCs) 影响了近一半的体外生命支持 (ECLS) 后的患者,导致诸如流体泄漏和感染等问题,主要发生在沟部位.

科学领域:

关键护理医学关键护理医学
手术部位感染手术部位感染
身体外膜氧化 (ECMO) 是一种方法.

背景情况:

身体外生命支持 (ECLS) 对急性心脏/呼吸系统衰竭至关重要,但存在风险.
管部位的并发症会扰乱愈合,增加患者的发病率和医疗费用.
关于ECLS后这些特定伤口并发症的流行病学数据有限.

研究的目的:

描述ECLS患者与管相关的伤口并发症 (CRWCs) 的发生率和特征.
为了识别ECLS脱后与CRWC相关的风险因素.
提高对CRWC作为ECLS后显著并发症的认识.

主要方法:

对ECLS患者 (2018-2023) 的回顾性,单中心队列研究.
包括接受静脉 (VV) 或静脉动脉 (VA) ECLS>24小时并成功断奶的患者.
描述性统计和单变物流回归分析了CRWC发生率,特征和风险因素.

主要成果:

在73名ECLS患者中,有45%的患者经历了37次CRWC,主要是液体泄漏 (90%),组织亡 (76%) 和伤口枯 (70%).
并发症主要发生在沟上,大约在脱后的第7天出现.
风险因素包括年龄较大,BMI较低,白蛋白水平较低,VA管道,手术插入和双管道.

结论:

在ECLS幸存者中,CRWC很常见 (45%),表现为严重的伤口愈合障碍.
沟管部位受到影响最多,并发症往往会延迟.
早期识别风险患者和识别CRWC对于改善患者的治疗结果至关重要.

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