JAHA:挥发性麻醉剂对术后缺血性卒中发生率的影响

2021-02-27 MedSci原创 MedSci原创

临床前研究表明,挥发性麻醉剂可减少梗死体积并改善缺血性卒中的预后。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,这项研究旨在明确非心脏手术中使用挥发性麻醉剂对术后缺血性卒中发生率的影响。

临床前研究表明,挥发性麻醉剂可减少梗死体积并改善缺血性卒中的预后。

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,这项研究旨在明确非心脏手术中使用挥发性麻醉剂对术后缺血性卒中发生率的影响。

这是一项回顾性队列研究,研究对象为2005年10月至2017年9月期间在马萨诸塞州波士顿两个三级医疗中心接受全麻手术的患者。该研究的排出标准为脑死亡、年龄<18岁、心脏手术以及缺少协变量数据的患者。该研究的暴露因素为术中测量经年龄调整的地氟醚、七氟醚和异氟烷的最低肺泡浓度。该研究的主要结局为术后30天内发生的缺血性卒中。

在314932例患者中,有1957例(0.6%)患者发生了主要结局。较高剂量的麻醉剂对术后缺血性卒中的发生具有保护性作用(最低肺泡浓度每增加一个SD的调整比值比为0.49、95%CI为0.40-0.59,P<0.001)。在Cox比例风险回归中,这一效应在术后17天仍可看到(术后第1天:风险比(HR)为0.56;95%CI为0.48-0.65;与第17天相比:HR为0.85;95%CI为0.74-0.99)。挥发性麻醉药还与较低的卒中严重程度相关:最低肺泡浓度每升高1个单位与美国国立卫生研究院卒中量表降低0.006单位相关(95%CI为-0.01至-0.002,P=0.002)。

由此可见,在接受非心脏手术的患者中,挥发性麻醉剂对术后早期缺血性卒中的发生率和严重程度具有剂量依赖性的保护效应

原始出处:

Dana Raub.et al.Effects of Volatile Anesthetics on Postoperative Ischemic Stroke Incidence.J AM HEART ASSOC.2021.https://www.ahajournals.org/doi/10.1161/JAHA.120.018952

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    2021-03-01 科研科研科研

    麻醉剂对术后缺血性卒中的发生率有影响

    0

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    2021-03-01 zhaohui6731
  5. [GetPortalCommentsPageByObjectIdResponse(id=1893357, encodeId=f7de189335eb2, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu Dec 23 03:48:29 CST 2021, time=2021-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826675, encodeId=7e5418266e5ac, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Sun Jun 20 20:48:29 CST 2021, time=2021-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944417, encodeId=c5c794441eff, content=麻醉剂对术后缺血性卒中的发生率有影响, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Mon Mar 01 12:59:00 CST 2021, time=2021-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268438, encodeId=06b8126843897, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon Mar 01 01:48:29 CST 2021, time=2021-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944039, encodeId=add894403924, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59e65457043, createdName=ms4000001548147119, createdTime=Sat Feb 27 22:04:14 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=943960, encodeId=806894396007, content=good, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200915/ec603ffd8acb4afbb590cc76c379eec8/15e20a86be294b0b849c23c74696a0af.jpg, createdBy=24da2086980, createdName=麻辣香薰, createdTime=Sat Feb 27 15:39:26 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806424, encodeId=edda18064240f, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Thu Jan 06 03:48:29 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026775, encodeId=20fb1026e759a, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sat Feb 27 13:48:29 CST 2021, time=2021-02-27, status=1, ipAttribution=)]
    2021-02-27 ms4000001548147119

    学习了

    0

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    2021-02-27 麻辣香薰

    good

    0

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  8. [GetPortalCommentsPageByObjectIdResponse(id=1893357, encodeId=f7de189335eb2, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu Dec 23 03:48:29 CST 2021, time=2021-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826675, encodeId=7e5418266e5ac, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Sun Jun 20 20:48:29 CST 2021, time=2021-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944417, encodeId=c5c794441eff, content=麻醉剂对术后缺血性卒中的发生率有影响, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Mon Mar 01 12:59:00 CST 2021, time=2021-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268438, encodeId=06b8126843897, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon Mar 01 01:48:29 CST 2021, time=2021-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944039, encodeId=add894403924, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59e65457043, createdName=ms4000001548147119, createdTime=Sat Feb 27 22:04:14 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=943960, encodeId=806894396007, content=good, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200915/ec603ffd8acb4afbb590cc76c379eec8/15e20a86be294b0b849c23c74696a0af.jpg, createdBy=24da2086980, createdName=麻辣香薰, createdTime=Sat Feb 27 15:39:26 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806424, encodeId=edda18064240f, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Thu Jan 06 03:48:29 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026775, encodeId=20fb1026e759a, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sat Feb 27 13:48:29 CST 2021, time=2021-02-27, status=1, ipAttribution=)]
    2021-02-27 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

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