大膈疝患者缺铁性贫血的危险因素是乙酰水杨酸摄入和高龄。

IF 1.8 3区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Digestive Surgery Pub Date : 2022-01-01 DOI:10.1159/000529326
Christoph G Dietrich, Tanja Kottmann, Annette Holtdirk, Joachim W Heise
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引用次数: 0

摘要

在15%的缺铁性贫血患者中,发现大膈疝是慢性铁流失的原因。相反,10-40%的膈疝患者存在缺铁性贫血。然而,目前尚不清楚为什么有些大膈疝患者会发生贫血,而另一些则不会。方法:回顾性分析116例大于5 cm膈疝存在贫血及手术治疗对贫血的影响,将患者分为4组(A组:有贫血/手术21例,B组:无贫血但手术27例,C组:有贫血但不手术34例,D组:无贫血/手术34例)。结果:女性在患者群体中占明显优势(76%)。缺铁性贫血患者明显大于无缺铁性贫血患者(74.7±12.2∶69.6±14.8岁,p = 0.08)。在贫血组中,服用ASA的患者比例明显高于对照组(41.8% vs. 9.8%, p < 0.001)。回归分析进一步证实,年龄增大和ASA摄入与贫血患者血红蛋白降低显著相关。行疝修补术显著降低贫血患者的贫血率和PPI的使用,而在未手术的贫血患者中两者几乎保持不变。结论:ASA的使用和高龄是大膈疝患者缺铁性贫血的危险因素。外科疝修补术适合减少贫血。
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Intake of Acetylsalicylic Acid and High Age Are Risk Factors for Iron Deficiency Anemia in Patients with Large Diaphragmatic Hernias.

Introduction: In 15% of patients with iron deficiency anemia, large diaphragmatic hernias are found as the cause of chronic iron loss. Conversely, iron deficiency anemia is present in 10-40% of diaphragmatic hernia patients. However, it is unclear why some patients with large diaphragmatic hernias develop anemia and others do not.

Methods: We retrospectively analyzed 116 patients with diaphragmatic hernias larger than 5 cm for the presence of anemia and the effect of surgery on this anemia, dividing these patients into 4 groups (group A: 21 patients with anemia/surgery, group B: 27 patients without anemia but with surgery, group C: 34 patients with anemia but without surgery, and group D: 34 patients without anemia/surgery).

Results: Women significantly predominated in the patient population (76%). Patients with iron deficiency anemia tended to be significantly older than patients without iron deficiency anemia (74.7 ± 12.2 vs. 69.6 ± 14.8 years, p = 0.08). The proportion of patients taking ASA was significantly higher in the anemia collective (41.8% vs. 9.8%, p < 0.001). Regression analysis further confirmed that higher age and ASA intake correlated significantly with lower hemoglobin in anemic patients. Performing hernia repair significantly decreased anemia rates and PPI use in the anemia patients, while both remained almost the same in the non-operated anemia patients.

Conclusion: ASA use and advanced age are risk factors for the presence of iron deficiency anemia in patients with large diaphragmatic hernias. Surgical hernia repair is suitable to reduce anemia.

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来源期刊
Digestive Surgery
Digestive Surgery 医学-外科
CiteScore
4.90
自引率
3.70%
发文量
25
审稿时长
3 months
期刊介绍: ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.
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