摘要
目的探讨不同表面处理技术对颅内动脉瘤患者接受血流导向密网支架(Flow Diverter,FD)植入术后围手术期出血风险、手术效率、术后恢复及抗血小板用药负担的影响,为临床选择提供循证依据。方法回顾分析首都医科大学宣武医院FD植入的患者共1972例,按患者所使用支架的表面处理类型不同分为抛光、涂层和无表面处理3组。重点比较无特殊合并症病例1217例在手术时长、术中出血量、术后出院天数及术后抗血小板用药次数。结果3组术中出血量差异无统计学意义(H=3.749,P=0.153),中位出血量均为10 mL,提示不同表面处理未增加即刻出血风险。3组手术时间差异显著(H=24.312,P<0.05),抛光组与涂层组手术时间均显著短于无表面处理组(P<0.05)。术后出院时间3组间差异显著(H=76.899,P<0.05),抛光组中位时间最短(1.85 d),其次为涂层组(1.95 d),无表面处理组最长(2.58 d),两两比较差异均有统计学意义(P<0.05)。3组抗血小板用药次数总体差异显著(H=10.461,P<0.05),多重比较显示,仅抛光组与无表面处理组间差异显著(P<0.05),其余组间差异无统计学意义(P>0.05)。结论在FD植入这一低出血风险场景中,抛光与涂层表面处理未增加即刻出血事件,且显著缩短手术时间与术后住院时间,抛光还可降低抗血小板用药负担,具有良好的安全性与临床效率优势。
Objective To investigate the effects of various surface treatment techniques on the perioperative bleeding risk,surgical efficiency,postoperative recovery,and antiplatelet medication burden in patients with intracranial aneurysms undergoing flow diverter(FD)stenting.The goal is to provide evidence-based guidance for clinical decision-making.Methods A retrospective analysis was conducted on 1972 patients who underwent FD implantation in Xuanwu Hospital,Capital Medical University.The patients were divided into three groups according to the surface treatment type of the stents they received:polishing group,coating group and nonsurface treatment group.A total of 1217 cases without special comorbidities were selected for focused comparison,with the operative duration,intraoperative blood loss,postoperative length of hospital stay and frequency of postoperative antiplatelet medication administration as the key outcome measures.Results No statistically significant difference was found in intraoperative blood loss among the three groups(H=3.749,P=0.153),with the median blood loss of 10 mL in each group,suggesting that different surface treatment methods did not increase the immediate bleeding risk.There was a significant difference in operative duration among the three groups(H=24.312,P<0.05),and the operative duration in both the polishing group and the coating group was significantly shorter than that in the non-surface treatment group(P<0.05).The postoperative length of hospital stay differed significantly among the three groups(H=76.899,P<0.05),the median length of hospital stay was the shortest in the polishing group(1.85 d),followed by the coating group(1.95 d)and the non-surface treatment group(2.58 d),with statistically significant differences observed in all pairwise comparisons(P<0.05).There was a significant overall difference in the frequency of antiplatelet medication use among the three groups(H=10.461,P<0.05).Multiple comparisons showed that a significant difference was detected only between the polishing group and the non-surface treatment group(P<0.05),while no statistically significant differences were identified between the other groups(P>0.05).Conclusion In the scenario of FD implantation with low bleeding risk,both polishing and coating surface treatments do not increase the incidence of immediate bleeding events,and can significantly shorten the operative duration and postoperative length of hospital stay.In addition,polishing can reduce the burden of antiplatelet medication,thus demonstrating favorable safety and advantages in clinical efficiency.
作者
李东
乔磊
程佳佳
吴萍
柳渊
吴航
董硕
LI Dong;QIAO Lei;CHENG Jiajia;WU Ping;LIU Yuan;WU Hang;DONG Shuo(Department of Medical Engineering,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《中国医疗设备》
2025年第12期36-41,共6页
China Medical Devices
基金
《中国医疗设备》杂志社课题(2025-CMDKT-01-001)
