JAMA Surg:预防性脾脏动脉栓塞术对脾破裂高风险患者脾脏挽救率的影响

2020-09-22 MedSci原创 MedSci原创

因外伤导致脾破裂高风险患者,接受预防性脾脏动脉栓塞术不会提高脾脏挽救率

脾脏动脉栓塞术(SAE)提高了脾破裂抢救的成功率,近日研究人员比较了预防性SAE(pSAE)与必要时栓塞(SURV)对脾破裂高危患者预后的影响。

研究在法国的16家医疗中心开展,133名外伤性脾破裂高危患者随机接受pSAE或SURV,研究的主要终点是创伤后1个月CT检测中脾脏至少50%血管化实质化的患者比例,次要终点包括脾切除术和假性动脉瘤,继发性SAE,并发症,住院时间,生活质量评分。

133名患者参与研究,其中男性105名,平均年龄30岁,57例接受pSAE患者,60例接受SURV患者接受了主要终点分析。pSAE组和SURV组在第1个月的CT检测中,脾脏至少50%血管化实质的数量没有显著差异(56 vs 56例,98.2% vs 93.3%)。pSAE组患者的脾假性动脉瘤发生率低于SURV(1.5% vs 12.3%),pSAE组患者的继发性栓塞率低于SURV组(1.5% vs 29.2%),组间总并发症发生率没有差异(29.2% vs 41.5%)。pSAE组患者的中位住院时间明显短于SURV组(9天 vs 13天)。

研究认为,因外伤导致脾破裂高风险患者,接受预防性脾脏动脉栓塞术不会提高脾脏挽救率。

原始出处:

Catherine Arvieux et al. Effect of Prophylactic Embolization on Patients With Blunt Trauma at High Risk of Splenectomy A Randomized Clinical Trial.JAMA Surg. September 16, 2020.

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    2020-10-10 1352755196m

    对于治疗有一定指导意义

    0

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    2020-09-22 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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