Surgical and obstetric outcomes in adults with sickle cell disease.
Surgical and obstetric outcomes in adults with sickle cell disease.
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DOI：
10.1016/j.amjmed.2008.04.040
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发表时间：
2008-10
影响因子：
5.9
通讯作者：
De Castro, Laura M.
中科院分区：
文献类型：
--
作者：
Adam, Soheir;Jonassaint, Jude;Kruger, Hillary;Kail, Melanie;Orringer, Eugene P.;Eckman, James R.;Ashley-Koch, Allison;Telen, Marilyn J.;De Castro, Laura M.
镰状细胞病患者比一般人群更有可能接受手术，并且通常在更年轻的时候这样做。女性镰状细胞病患者也有特殊的妇科和产科问题与他们的疾病。我们通过标准化的临床报告表、患者访谈和医疗记录收集了509例成人镰状细胞病患者的数据。Logistic回归用于估计多个变量与每种手术类型之间的相关性。我们还确定了该人群中284例镰状细胞病妇女的患病率和妊娠结局。几乎50%的18-27岁患者接受过胆囊切除术。平均红细胞血红蛋白、总胆红素和乳酸脱氢酶在胆囊切除术后组显著升高; 504例患者中有9.5%接受了脾切除术。脾切除术后组的红细胞压积、体重指数和红细胞计数显著升高。9.2%的人进行了髋关节置换术，患病率早在40岁时就开始增加，并在60岁时继续增加。190名妇女（67%）有妊娠史。在410例妊娠中，只有53.9%活产，16.6%自愿终止妊娠，29.5%并发流产、死产或异位着床。镰状细胞病继续对普通手术的平均年龄产生强烈影响，并影响妊娠结局。我们的结论是，这一人群有一个独特的手术和产科史，应进一步研究，以提供更有效的预防终末器官损伤的方法。
Sickle cell disease patients are more likely than the general population to undergo surgery and usually do so at a younger age. Female sickle cell disease patients also have special gynecological and obstetric issues related to their disease. We collected data through standardized clinical report forms, patient interviews, and medical records from 509 adult sickle cell disease patients. Logistic regression was used to estimate the association between multiple variables and each of the surgery types. We also determined the prevalence and outcomes of pregnancy in 284 women with sickle cell disease in this population. Almost 50% of patients aged 18–27 years had had a cholecystectomy. Mean corpuscular hemoglobin, total bilirubin, and lactate dehydrogenase were significantly higher in the postcholecystectomy group; 9.5% of 504 individuals had undergone splenectomy. Hematocrit, body mass index, and red blood cell count were significantly higher in the postsplenectomy group. Hip replacement had been performed in 9.2% of individuals, with the prevalence increasing as early as the fourth decade and continuing to increase through the sixth decade of life. A history of pregnancy was present in 190 women (67%). Of 410 pregnancies, only 53.9% resulted in live births, 16.6% were voluntarily terminated, and 29.5% were complicated by miscarriage, still birth, or ectopic implantation. Sickle cell disease continues to have a strong effect on the mean age for common surgeries and impacts pregnancy outcomes. We conclude that this population has a unique surgical and obstetric history that should be further studied to provide insight into potentially more effective preventive approaches to end-organ damage.
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DOI：
10.1186/ar387
发表时间：
2002
期刊：
Arthritis research
影响因子：
--
作者：
Marks R;Allegrante JP
通讯作者：
Allegrante JP
影响因子：
2.4
作者：
Buck, J;Davies, SC
通讯作者：
Davies, SC
影响因子：
12.8
作者：
Chaar, Vicky;Keclard, Lysiane;Romana, Marc
通讯作者：
Romana, Marc
影响因子：
--
作者：
Hamilton, BE;Ventura, SJ
通讯作者：
Ventura, SJ
影响因子：
3.1
作者：
Adekile, A;Kutlar, F;Kutlar, A
通讯作者：
Kutlar, A