抑郁症与慢性四肢威胁性缺血症中较低的无截肢生存率的关联
Ilse Torres Ruiz1, Cuneyt Koksoy1, Zachary S Pallister1
1Division of Vascular Surgery and Endovascular Therapy, Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
The Journal of surgical research
|January 13, 2026
概括
抑郁症影响了近三分之一的慢性肢体威胁性缺血症 (CLTI) 患者,并显著增加了截肢的风险. 早期查和综合心理社会护理对于改善CLTI患者的治疗结果至关重要.
科学领域:
- 血管外科 血管外科
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 慢性四肢威胁性缺血症 (CLTI) 是一种严重的外周动脉疾病形式,导致严重的心理社会困扰,包括抑郁症.
- 在CLTI患者中,抑郁症往往被诊断不足,其对临床结果的影响还不太清楚.
研究的目的:
- 为了确定CLTI患者抑郁症的患病率.
- 评估抑郁症对临床结果的影响,包括肢体救援和生存.
主要方法:
- 在2010年12月至2024年1月期间接受治疗的801名CLTI患者的回顾性分析.
- 收集的数据包括人口统计,并发病,缺血指标,再血管化手术,截肢,肢体救援和生存率.
- 统计分析涉及二元物流回归和卡普兰-梅尔生存估计.
主要成果:
- 在31.8%的CLTI患者中存在抑郁症.
- 抑郁症患者的重大截肢率显著更高 (25.5%与16.7%相比),截肢无需存活率和整体存活率在20个月的随访后更低.
- 与抑郁症相关的因素包括女性性别,充血性心力衰竭,甲状腺功能低下和活跃吸烟.
结论:
- 抑郁症在CLTI患者中很常见,并且与失去四肢的风险更高有关.
- 建议进行常规抑郁查和综合心理社会护理,以改善CLTI患者的治疗结果.
- 需要进一步研究,以了解CLTI中抑郁症的机制并开发抑郁症干预措施.
相关概念视频
01:23Peripheral Artery Disease V: Postoperative Nursing Management
372
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
372
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
349
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
349
01:26Peripheral Artery Disease IV: Nursing Management
347
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
347
01:27Peripheral Artery Disease III: Interprofessional Care
237
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
237
01:30Peripheral Artery Disease I: Introduction
310
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
310