术后减肥对抗凝血剂剂剂量的影响,主要的下肢截肢后的下肢截肢
A Al-Kassar1, A Okram1, K Poluru1
1Countess of Chester Hospital, UK.
Annals of the Royal College of Surgeons of England
|January 20, 2026
概括
主要下肢截肢患者经历了显著的体重减轻,但抗凝剂剂量很少被调整. 这凸显了需要进行例行体重监测,以确保准确的药物剂量和患者安全.
科学领域:
- 血管外科 血管外科
- 药理学 药理学是指药理学的学科.
- 患者安全 患者安全
背景情况:
- 慢性肢体威胁性缺血常常需要进行较大的下肢截肢.
- 手术后减肥是截肢后的一个常见并发症.
- 体重变化可能会影响体重依赖抗凝剂剂量的准确性.
研究的目的:
- 为了评估手术后减肥的程度,在接受主要下肢截肢的患者.
- 在日常实践中确定抗凝剂剂量调整的频率.
- 评估抗凝剂治疗中体重变化的临床相关性.
主要方法:
- 对经过膝盖以上或膝盖以下截肢的患者进行了回顾性队列研究.
- 包括在低分子量肝素 (LMWH) 或直接口服抗凝剂 (DOACs) 上记录了手术前和手术后体重的患者.
- 对抗凝血剂剂量与英国国家表单基于体重的建议的审查.
主要成果:
- 平均术后体重减轻是手术前体重的7.5%.
- 膝盖以上截肢导致更大的体重减轻 (平均8.7kg) 与膝盖以下截肢 (平均3.8kg) 相比.
- 只有11.8%的患者需要调整抗凝剂剂量,尽管体重显著下降.
结论:
- 大型截肢与临床显著的术后体重减轻有关.
- 在这个队列中,抗凝剂剂量调整很少发生.
- 建议进行常规的术后体重监测和及时的药物检查,以优化剂量准确性和减轻抗凝风险.
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