JAMA:脑栓塞保护装置对主动脉瓣置换术中枢神经系统梗死的影响

2017-08-10 zhangfan MedSci原创

对于进行主动脉瓣置换术的患者,与标准主动脉插管相比,脑栓塞保护装置未能显著降低7天内中枢神经系统梗死风险,对于术后谵妄、认知以及中风症状的改善需要进行长期的监测确认。

脑卒中是主动脉瓣置换术(SAVR)的主要并发症。近日研究人员考察了SAVR过程中脑栓塞保护装置对减少缺血中枢神经系统损伤的作用以及不良事件。研究在2015-16年开展,北美18个医疗中心参与。患者在主动脉瓣置换术过程中,随机使用脑栓塞保护装置(抽吸提取装置[n=118]或主动脉内过滤装置[n=133])或标准的主动脉插管(对照,n=132)。研究的主要终点是术后4-10天内临床或影像学确诊的中枢神经系统梗塞。次要终点包括复合的死亡率,手术后30天内临床缺血性中风和急性肾损伤,谵妄,死亡率,严重不良事件和神经认知障碍。383人参与研究,平均年龄73.9岁,女性38.4%,368人完成研究。相比于对照组(33.3%),抽吸提取装置组主要终点发生率为32.0%,组间差异-1.3%;主动脉内过滤装置组主要终点发生率为25.6%,组间差异-6.9%。30天的复合死亡率、死亡率以及临床中风发病率各组间无显著差异。术后7天的谵妄发病率:抽吸提取装置组vs对照组,6.3%vs 15.3%(组间差异-9.1%);主动脉内过滤装置组vs对照组,8.1% vs 15.6%(组间差异-7.4%)。术后90天的

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    2018-01-10 yxch48
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  5. 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  6. 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    2017-08-11 axin013
  7. 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  8. 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  9. 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href='/topic/show?id=a9b2222e60a' target=_blank style='color:#2F92EE;'>#中枢神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22276, encryptionId=a9b2222e60a, topicName=中枢神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1fcf20658765, createdName=smlt2015, createdTime=Fri Aug 11 23:59:00 CST 2017, time=2017-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232119, encodeId=c439232119e6, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Aug 10 10:20:34 CST 2017, time=2017-08-10, status=1, ipAttribution=), 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    2017-08-10 Y—xianghai

    学习了新知识

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=232115, encodeId=cd4f232115c5, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Thu Aug 10 10:15:32 CST 2017, time=2017-08-10, status=1, ipAttribution=)]
    2017-08-10 李东泽

    很好,不错,以后会多学习

    0