NEJM:血栓切除对巴西中风患者90天预后的改善效果

2020-06-11 MedSci原创 MedSci原创

像巴西这种中低收入国家,在中风症状出现后8小时内,联合使用标准护理及血管内治疗可显著改善患者90天功能结果

近日研究人员考察了血栓切除术对巴西脑卒中患者预后的影响。
 
研究人员研究了血栓切除在巴西公共卫生系统中的安全性和有效性。 在12家公立医院中,脑卒中症状出现后8小时内的前循环近端颅内闭塞患者,在标准护理基础上,随机接受机械血栓切除或对照。 主要结果是在90天的改良Rankin评分(0[无症状]-6[死亡])。
 
300名患者参与研究,其中79名患者在开放式转诊期间接受了血栓切除术。约70%的人接受静脉注射阿替普酶。其他221名患者接受了随机分组,其中111名接受血栓切除,110名为对照。在90天的修正Rankin评分方面,血栓切除组预后更有优势(2.28)。无神经功能缺损或轻度神经功能缺损患者(改良Rankin评分0至2)比例,血栓切除组为35.1%,对照组为20.0 (差异15.1%)。血栓切除组51.4%的患者和对照组24.5%的患者出现无症状颅内出血;各有4.5%的患者出现症状性颅内出血。
 
研究认为,像巴西这种中低收入国家,在中风症状出现后8小时内,联合使用标准护理及血管内治疗可显著改善患者90天功能结果。
 
原始出处
 
Sheila O. Martins et al. Thrombectomy for Stroke in the Public Health Care System of Brazil. N Engl J Med, June 11, 2020.

 

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    2020-06-11 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1314291, encodeId=e8c61314291bc, content=<a href='/topic/show?id=585189089f4' target=_blank style='color:#2F92EE;'>#血栓切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89089, encryptionId=585189089f4, topicName=血栓切除)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=284b425, createdName=zll0625, createdTime=Sat Jun 13 09:23:25 CST 2020, time=2020-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1538094, encodeId=184e15380949a, content=<a href='/topic/show?id=e835226210e' target=_blank style='color:#2F92EE;'>#中风患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22621, encryptionId=e835226210e, topicName=中风患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1b5612933772, createdName=sunylz, createdTime=Sat Jun 13 09:23:25 CST 2020, time=2020-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1580883, encodeId=be741580883b4, content=<a href='/topic/show?id=cc274831170' target=_blank style='color:#2F92EE;'>#巴西#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48311, encryptionId=cc274831170, topicName=巴西)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=81dd16663079, createdName=ms9833124466084992, createdTime=Sat Jun 13 09:23:25 CST 2020, time=2020-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035303, encodeId=dbd81035303e2, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jun 11 21:23:25 CST 2020, time=2020-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045966, encodeId=053010459666f, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Jun 11 21:23:25 CST 2020, time=2020-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047074, encodeId=a562104e07406, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Thu Jun 11 21:23:25 CST 2020, time=2020-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602060, encodeId=1d6c60206005, content=<a href='/topic/show?id=fa10e93597f' target=_blank style='color:#2F92EE;'>#缺血性卒中#</a>血管内血栓切除术俨然是有效的,即使是超过六个小时,有可能是有效。, beContent=null, objectType=article, channel=null, level=null, likeNumber=182, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79359, encryptionId=fa10e93597f, topicName=缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jun 11 19:52:31 CST 2020, time=2020-06-11, status=1, ipAttribution=)]
    2020-06-11 guging

    中风是俗称,应该称为缺血性卒中吧

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1314291, encodeId=e8c61314291bc, content=<a href='/topic/show?id=585189089f4' target=_blank style='color:#2F92EE;'>#血栓切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89089, encryptionId=585189089f4, topicName=血栓切除)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=284b425, createdName=zll0625, createdTime=Sat Jun 13 09:23:25 CST 2020, time=2020-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1538094, encodeId=184e15380949a, content=<a href='/topic/show?id=e835226210e' target=_blank style='color:#2F92EE;'>#中风患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22621, encryptionId=e835226210e, topicName=中风患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1b5612933772, createdName=sunylz, createdTime=Sat Jun 13 09:23:25 CST 2020, time=2020-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1580883, encodeId=be741580883b4, content=<a href='/topic/show?id=cc274831170' target=_blank style='color:#2F92EE;'>#巴西#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48311, encryptionId=cc274831170, topicName=巴西)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=81dd16663079, createdName=ms9833124466084992, createdTime=Sat Jun 13 09:23:25 CST 2020, time=2020-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035303, encodeId=dbd81035303e2, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jun 11 21:23:25 CST 2020, time=2020-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045966, encodeId=053010459666f, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Jun 11 21:23:25 CST 2020, time=2020-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047074, encodeId=a562104e07406, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Thu Jun 11 21:23:25 CST 2020, time=2020-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602060, encodeId=1d6c60206005, content=<a href='/topic/show?id=fa10e93597f' target=_blank style='color:#2F92EE;'>#缺血性卒中#</a>血管内血栓切除术俨然是有效的,即使是超过六个小时,有可能是有效。, beContent=null, objectType=article, channel=null, level=null, likeNumber=182, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79359, encryptionId=fa10e93597f, topicName=缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jun 11 19:52:31 CST 2020, time=2020-06-11, status=1, ipAttribution=)]
    2020-06-11 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1314291, encodeId=e8c61314291bc, content=<a href='/topic/show?id=585189089f4' target=_blank style='color:#2F92EE;'>#血栓切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89089, encryptionId=585189089f4, topicName=血栓切除)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=284b425, createdName=zll0625, createdTime=Sat Jun 13 09:23:25 CST 2020, time=2020-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1538094, encodeId=184e15380949a, content=<a href='/topic/show?id=e835226210e' target=_blank style='color:#2F92EE;'>#中风患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22621, encryptionId=e835226210e, topicName=中风患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1b5612933772, createdName=sunylz, createdTime=Sat Jun 13 09:23:25 CST 2020, time=2020-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1580883, encodeId=be741580883b4, content=<a href='/topic/show?id=cc274831170' target=_blank style='color:#2F92EE;'>#巴西#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48311, encryptionId=cc274831170, topicName=巴西)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=81dd16663079, createdName=ms9833124466084992, createdTime=Sat Jun 13 09:23:25 CST 2020, time=2020-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035303, encodeId=dbd81035303e2, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jun 11 21:23:25 CST 2020, time=2020-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045966, encodeId=053010459666f, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Jun 11 21:23:25 CST 2020, time=2020-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047074, encodeId=a562104e07406, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Thu Jun 11 21:23:25 CST 2020, time=2020-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602060, encodeId=1d6c60206005, content=<a href='/topic/show?id=fa10e93597f' target=_blank style='color:#2F92EE;'>#缺血性卒中#</a>血管内血栓切除术俨然是有效的,即使是超过六个小时,有可能是有效。, beContent=null, objectType=article, channel=null, level=null, likeNumber=182, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79359, encryptionId=fa10e93597f, topicName=缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jun 11 19:52:31 CST 2020, time=2020-06-11, status=1, ipAttribution=)]
    2020-06-11 lovetcm

    #缺血性卒中#血管内血栓切除术俨然是有效的,即使是超过六个小时,有可能是有效。

    0

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