Suppr超能文献

一种用于接受减肥手术患者的简单静脉血栓栓塞预防方案。

A simple venous thromboembolism prophylaxis protocol for patients undergoing bariatric surgery.

作者信息

Frezza Eldo E, Wachtel Mitchell S

机构信息

Department of Surgery, Division of General Surgery, Texas Tech University Health Sciences Center, MOP Building, Suite 380, 3502 9th Street, Lubbock, TX 79415, USA.

出版信息

Obesity (Silver Spring). 2006 Nov;14(11):1961-5. doi: 10.1038/oby.2006.229.

Abstract

OBJECTIVE

Pulmonary embolism is a leading cause of death for bariatric patients. Numerous regimens have been proposed, but a comprehensive, simple approach is lacking. This study provides a simple, easily implemented prophylaxis regimen.

RESEARCH METHODS AND PROCEDURES

One hundred fifty bariatric surgery patients were evaluated. Patients considered at high risk for venous thromboembolism had heart failure, a BMI of >/=50 kg/m(2), or a history of venous thromboembolism or pelvic surgery. Preoperatively and postoperatively, all patients received subcutaneous enoxaparin or unfractionated heparin. High-risk patients received either preoperatively inserted inferior vena cava filters or continuous heparin infusions intraoperatively. All high-risk patients were anticoagulated with warfarin (Coumadin; Bristol Myers-Squibb, Princeton, NJ) for at least 3 months postoperatively. Initially, some patients experienced significant hemorrhage; to prevent this, sutures were oversewn into staple lines.

RESULTS

No patient experienced venous thromboembolism; a binomial test showed that the regimen reduced the risk of this complication to less than 2% (p < 0.05). Hemorrhage sufficient to require transfusion occurred in 4 of the first 20 patients; of the remaining 130 patients, into whose staple lines sutures were oversewn, none required transfusion (p < 0.05).

DISCUSSION

Patients should be divided into those who are at high risk and those who are at low risk for venous thromboembolism. All patients should receive pre- and postoperative anticoagulation. High-risk patients should also receive either an inferior vena cava filter or intraoperative heparin infusions, as well as at least 3 months of Coumadin therapy. Oversewing of staple lines may reduce the risk of hemorrhage.

摘要

目的

肺栓塞是肥胖症患者死亡的主要原因。虽然已经提出了多种治疗方案,但仍缺乏一种全面、简单的方法。本研究提供了一种简单、易于实施的预防方案。

研究方法与步骤

对150例肥胖症手术患者进行了评估。被认为静脉血栓栓塞高风险的患者有心力衰竭、体重指数(BMI)≥50kg/m²、静脉血栓栓塞病史或盆腔手术史。术前和术后,所有患者均接受皮下注射依诺肝素或普通肝素。高风险患者术前接受下腔静脉滤器植入或术中持续肝素输注。所有高风险患者术后至少3个月接受华法林(香豆素;百时美施贵宝公司,新泽西州普林斯顿)抗凝治疗。最初,一些患者出现了严重出血;为预防这种情况,在吻合钉行处进行了缝合加固。

结果

没有患者发生静脉血栓栓塞;二项式检验表明,该方案将这种并发症的风险降低至2%以下(p<0.05)。前20例患者中有4例发生了需要输血的出血;在其余130例进行了吻合钉行缝合加固的患者中,无人需要输血(p<0.05)。

讨论

应将患者分为静脉血栓栓塞高风险和低风险两类。所有患者术前和术后均应接受抗凝治疗。高风险患者还应接受下腔静脉滤器植入或术中肝素输注,以及至少3个月的香豆素治疗。吻合钉行缝合加固可能会降低出血风险。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验