在开放腹腔大动脉动脉瘤修复过程中左静脉分裂
Ahmed Eissa-Garces1, Gabriel Cedeño2, José de Jesús Méndez Castro3
1Beth Israel Deaconess Medical Center, Division of Surgical Oncology, Harvard Medical School, Boston, USA; Universidad San Francisco de Quito, School of Medicine, Quito, Ecuador.
Journal of vascular surgery
|January 10, 2026
概括
根据对9项研究的元分析,在开放腹腔大动脉瘤修复过程中分裂左静脉不会增加30天的死亡率或对功能产生负面影响.
科学领域:
- 血管外科 血管外科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 手术结果研究研究.
背景情况:
- 开放腹腔大动脉瘤 (AAA) 修复是一种主要的手术程序.
- 在AAA修复期间,左静脉 (LRV) 的管理,特别是分裂与保存,是一个关键的外科决定.
- 了解LRV划分对患者结果的影响,对于手术规划和患者护理至关重要.
研究的目的:
- 系统地审查和分析现有文献,以评估左静脉 (LRV) 分裂对接受开放腹腔大动脉瘤 (AAA) 修复的患者的结果的影响.
- 评估LRV分裂与30天死亡率和功能 (短期和长期) 之间的关联.
主要方法:
- 根据Cochrane指南进行了系统审查和元分析,并注册了PROSPERO (CRD42025640222).
- 在PubMed,EMBASE和Cochrane数据库的搜索中,发现了比较开放AAA修复与没有LRV分裂的研究.
- 来自9项纳入研究 (1,324名患者) 的数据使用随机效应模型进行分析,以估计初级 (30天死亡率) 和二级 (功能) 结局的风险比和平均差异.
主要成果:
- 分析包括9项研究,涉及1324名患者 (350名具有LRV划分,974名没有).
- 在30天死亡率,急性损伤 (AKI),需要透析或排泄估计的膜过率 (eGFR) 之间没有发现显著差异.
- 在接受LRV分裂 (MD=0.08,95%CI 0.04-0.11,p=0.009) 的患者中观察到术后血清肌素 (sCr) 的统计学显著增加.
结论:
- 在开放的AAA修复过程中,左静脉的分裂与30天死亡率的增加无关.
- LRV分裂不会导致更糟糕的短期或长期功能结果.
- 虽然手术后的sCr随着LRV分裂略有升高,但整体功能和死亡率没有显著影响.
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