JAHA:生物移植物开放性修复腹主动脉瘤疗效分析!

2018-06-10 xing.T MedSci原创

由此可见,应用生物移植物修复真菌性腹主动脉瘤是一种可持久的选择,适合外科手术患者,具有良好的抗感染性和良好的总生存率。

霉菌性腹主动脉瘤的治疗需要外科手术和抗菌治疗。由于假体重建具有相当大的再感染风险,生物移植物是值得注意的替代物。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,该研究旨在评估生物移植治疗真菌性腹主动脉瘤的耐用性、抗感染性和中期结局。

在2006年至2016年期间,共有6个国家接受了生物移植治疗的患者纳入了研究。主要观察指标为30和90天生存率、治疗相关死亡率和再感染率。次要结局是总体死亡率和移植物通畅性。

该研究共纳入了五十六例(男性占46例)平均年龄为69岁(35-85岁)的患者。16例(29%)患者免疫功能低下,24例(43%)患者存在合并感染,12例(21%)患者出现主动脉瘤破裂。43例(77%)患者细菌培养阳性。30例(54%)患者采用自体股静脉行原位主动脉重建,12例(21%)患者进行异种心包移植管移植,9例(16%)患者接受深低温保存的动脉/静脉移植,5例(9%)患者接受新鲜动脉移植。在中位随访26个月(3周至172个月)期间,没有发生再感染病例,只有3例(5%)患者需要协助移植通畅。30天生存率为95%(n=53),90天生存率为91%(n=51)。治疗相关死亡率为9%(n=5)。卡普兰-梅耶1年生存率为83%(95%可信区间为73%-94%),5年生存率为71%(52%-89%)。

由此可见,应用生物移植物修复真菌性腹主动脉瘤是一种可持久的选择,适合外科手术患者,具有良好的抗感染性和良好的总生存率。

原始出处:

Ivika Heinola.et al. Open Repair of Mycotic Abdominal Aortic Aneurysms With Biological Grafts: An International Multicenter Study.JAHA.2018. https://doi.org/10.1161/JAHA.117.008104

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    2018-08-31 xuyong535
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    2018-06-20 虈亣靌

    学习了.谢谢分享!

    0

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    2018-06-12 zhaohui6731
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    2018-06-10 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0