贝切特病患者的术后并发症。
Postoperative complications in patients with Behçet's disease.
机构信息
Division of Rheumatology, Department of Internal Medicine, Seoul Metropolitan City Seoul Medical Center, Seoul, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
出版信息
Clin Rheumatol. 2024 Dec;43(12):3829-3838. doi: 10.1007/s10067-024-07212-y. Epub 2024 Oct 29.
OBJECTIVE
To assess the proportion of postoperative complications of various surgeries in patients with Behçet's disease (BD) and compare the risk of surgical complications between BD patients and controls.
METHODS
We analyzed 389 BD patients who underwent surgeries at Seoul National University Hospital between January 2003 and December 2019. Controls were 1:1 matched with BD patients based on age at surgery, sex, and type of surgery. Generalized estimating equation analyses were performed to compare the postoperative complications between BD patients and controls.
RESULTS
Among 632 surgeries in BD patients, 36 (5.7%) surgical site complications, including wound dehiscence (38.9%), bleeding (13.9%), infections (8.3%), anastomotic dehiscence (22.2%), and stricture (5.6%), occurred after median 12 days (IQR 7.8-22.0). Surgical site complications developed frequently after cardiac (33.3%) and vascular (22.2%) surgeries and rarely occurred after ophthalmic (1.5%) surgeries. Seventeen (2.7%) cases required reoperation within median 15 days (IQR 7.0-43.0). Four patients died within median 21 days (IQR 8.3-41.3 days). After adjustment for confounders, BD patients exhibited a significantly higher risk of surgical site complications (OR 3.4, 95% CI 1.4-8.0) and reoperation (OR 5.2, 95% CI 1.2-22.8) after cardiovascular surgery than controls. However, the risks of surgical site complications and reoperation after other types of surgery were similar in both groups.
CONCLUSIONS
The risk of postoperative complications varies according to the type of surgeries among BD patients. While cardiovascular surgeries result in higher perioperative complications in BD patients, ophthalmic surgeries show a safety profile similar to those in non-BD patients. Key Points • Patients with Behçet's disease exhibited an increased risk of surgical site complications and subsequent reoperations after cardiovascular surgery than controls. • The safety profile of ophthalmic surgery was comparable between patients with Behçet's disease and controls. • In patients with Behçet's disease, the risk of postoperative complications varies according to the type of surgery.
目的
评估贝切特病（BD）患者各种手术后并发症的比例，并比较 BD 患者与对照组之间手术并发症的风险。
方法
我们分析了 2003 年 1 月至 2019 年 12 月在首尔国立大学医院接受手术的 389 例 BD 患者。对照组根据手术时的年龄、性别和手术类型与 BD 患者 1:1 匹配。采用广义估计方程分析比较 BD 患者与对照组之间的术后并发症。
结果
在 632 例 BD 患者的手术中，术后 12 天内（IQR 7.8-22.0）发生了 36 例（5.7%）手术部位并发症，包括伤口裂开（38.9%）、出血（13.9%）、感染（8.3%）、吻合口裂开（22.2%）和狭窄（5.6%）。手术部位并发症常发生于心脏（33.3%）和血管（22.2%）手术后，很少发生于眼科（1.5%）手术后。中位 15 天内（IQR 7.0-43.0）有 17 例（2.7%）需要再次手术。4 例患者在中位 21 天内（IQR 8.3-41.3 天）死亡。调整混杂因素后，BD 患者心血管手术后手术部位并发症（OR 3.4，95%CI 1.4-8.0）和再次手术（OR 5.2，95%CI 1.2-22.8）的风险显著高于对照组。然而，两组其他类型手术的手术部位并发症和再次手术风险相似。
结论
BD 患者术后并发症的风险因手术类型而异。心血管手术后 BD 患者围手术期并发症发生率较高，而眼科手术后与非 BD 患者的安全性相似。
关键点
与对照组相比，BD 患者心血管手术后手术部位并发症和随后再次手术的风险增加。
BD 患者眼科手术后的安全性与对照组相当。
在 BD 患者中，术后并发症的风险因手术类型而异。
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