在脊椎多发性骨髓瘤相关的骨疾病中,高额手术内流血的预后因素
Jens P Te Velde1,2,3,4, Hester Zijlstra1,4,5, Daniël de Reus1
1Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
多发性骨髓瘤患者的脊柱手术会导致更高的血液损失. 较低的血小板计数,手术类型,脊柱水平位置和较长的手术持续时间预测了手术内出血的增加.
科学领域:
- 整形外科手术 整形外科手术
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 多发性骨髓瘤 (MM) 患者的脊柱手术往往涉及显著的手术内血液损失.
- 识别血液损失的预测因素对于患者管理和输血规划至关重要.
研究的目的:
- 在多发性骨髓瘤患者的脊柱手术期间,研究与更高的手术内流血相关的预后因素.
- 分析出血指数 (BI) 和估计失血 (EBL) 的预测因素.
主要方法:
- 追溯多中心队列研究,包括158名MM成年患者接受脊柱手术.
- 多变量通用线性模型 (GLMs) 用于评估BI和EBL的预测因素.
- 在2001年5月至2021年12月期间收集的数据.
主要成果:
- 平均BI为4.4,平均EBL为750毫升.
- 较低的血小板计数和较长的手术持续时间独立地与更高的BI相关.
- 与腰部手术相比,宫脊椎手术显示预期的BI减少了40.3%.
结论:
- 血小板计数,手术类型,脊柱水平位置和手术持续时间是MM患者手术内BI的独立预测因素.
- 这些发现可以为手术前查,决策和输血策略提供信息.
- 了解这些因素对于优化这种患者群体的手术结果至关重要.
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