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解读外路泪囊鼻腔吻合术的出血风险:相关因素的综合分析

Deciphering hemorrhagic risks in external dacryocystorhinostomy: a comprehensive analysis of associated factors.

作者信息

Karimi Bita, Eghtedari Masoomeh, Khademi Behzad, Nowroozzadeh Mohammad Hossein

机构信息

School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Ophthalmology, Poostchi Ophthalmology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Int Ophthalmol. 2025 May 9;45(1):185. doi: 10.1007/s10792-025-03544-z.

Abstract

PURPOSE

This study investigates the impact of herbs (Ginger, Garlic and Green tea) and perioperative factors on intraoperative and postoperative hemorrhage as well as ecchymosis in external dacryocystorhinostomy.

METHODS

This was a case series study that included 50 external DCR procedures performed on adults. Patients' herbal use and other risk factors were questioned before the surgery. During the procedure, intraoperative hemorrhage volume and other parameters were documented. Postoperative hemorrhage and ecchymosis were evaluated on the day following the surgery. We used Regression analysis to assess the factors associated with hemorrhage complications in external DCR.

RESULTS

The average amount of intraoperative hemorrhage was 81.66 ml. Moderate to severe postoperative hemorrhage and ecchymosis occurred in 27.7 and 40.8% of cases, respectively. Upon conducting linear regression analysis, intraoperative MAP was the only factor associated with intraoperative hemorrhage. A significant association of ginger and intraoperative MAP with postoperative hemorrhage was revealed through multiple regression analysis. Additionally, the factors associated with postoperative ecchymosis were older age and urban residence.

CONCLUSIONS

We identified several factors associated with hemorrhage complications in external DCR procedure, including ginger use, intraoperative MAP, older age, and urban residence. Based on our findings that ginger intake before surgery can increase the hemorrhage risk, patients should be meticulously questioned about ginger use prior to external DCR and be recommended to cease its use.

摘要

目的

本研究调查草药(生姜、大蒜和绿茶)及围手术期因素对外泪囊鼻腔造口术中及术后出血以及瘀斑的影响。

方法

这是一项病例系列研究,纳入了对成人进行的50例外部泪囊鼻腔造口术。术前询问患者的草药使用情况及其他风险因素。手术过程中,记录术中出血量及其他参数。术后第一天评估术后出血和瘀斑情况。我们使用回归分析来评估与外部泪囊鼻腔造口术出血并发症相关的因素。

结果

术中平均出血量为81.66毫升。分别有27.7%和40.8%的病例发生中度至重度术后出血和瘀斑。进行线性回归分析时,术中平均动脉压是与术中出血相关的唯一因素。通过多元回归分析发现生姜和术中平均动脉压与术后出血存在显著关联。此外,与术后瘀斑相关的因素是年龄较大和居住在城市。

结论

我们确定了外部泪囊鼻腔造口术出血并发症的几个相关因素,包括生姜使用、术中平均动脉压、年龄较大和居住在城市。基于我们的研究结果,术前摄入生姜会增加出血风险,在进行外部泪囊鼻腔造口术之前,应仔细询问患者生姜的使用情况,并建议其停止使用。

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