概括
系统性栓塞仍然是使用Starr-Edwards假肢的患者的重大风险,特别是在早期模型中. 长期随访显示持续的血栓栓塞事件影响生存和神经功能.
科学领域:
- 心血管外科心血管外科
- 生物材料科学 生物材料科学
- 临床流行病学 临床流行病学
背景情况:
- 斯塔尔-爱德华兹假肢被广泛用于关节和大动脉置换.
- 关于血栓栓塞的长期结果对于患者管理至关重要.
研究的目的:
- 为了评估系统性血栓栓塞的长期发病率和结果,在接受Starr-Edwards假肢的患者中进行中枢置换 (MVR) 和大动脉置换 (AVR).
主要方法:
- 在1962年至1971年期间接受了MVR或AVR的302名患者的回顾性研究.
- 随访时间为10年至19年.
- 对血栓塞栓事件的分析,包括脑栓塞,神经缺陷和死亡率.
主要成果:
- 对于整个队列来说,10年后66%的长期无系统血栓塞栓症,在15年后58%的系统血栓塞栓症.
- 最近的门模型显示,与早期的模型相比,10年自由率 (70% MVR,74% AVR) 更高.
- 大脑栓塞是最常见的,神经缺陷和死亡的比例很高.
- 不充分的抗凝剂和早期的 mitra 假肢模型 (模型 6000) 与更高的栓塞发病率有关.
结论:
- 系统性血栓塞是斯特尔-爱德华兹门更换后的一种持续性和显著的并发症.
- 抗凝管理和假肢模型是影响血栓栓塞风险的关键因素.
- 这些发现强调了需要仔细选择和监测患者的需要.
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