Stroke:COVID-19患者大血管闭塞所致急性缺血性卒中的治疗

2020-06-01 MedSci原创 MedSci原创

由此可见,包括早期静脉溶栓以及通过机械血栓切除术成功再通在内的以往最佳的治疗导致COVID-19患者预后较差。

在2019冠状病毒病(COVID-19)患者中观察到了更高的卒中发生率,但缺乏有关COVID-19患者因大血管闭塞(LVO)而导致急性缺血性卒中的结局数据。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员报告了COVID-19患者治疗LVO导致急性缺血性卒中的初步经验。

研究人员纳入所有在COVID-19爆发后的前6周内在研究者所在机构接受治疗的因LVO所致急性缺血性卒中的COVID-19患者。研究人员报告了受试者的基线临床和影像学结果、治疗和短期结局。

研究人员确定了10例确诊为LVO所致急性缺血性卒中的COVID-19患者。男性为8人,平均年龄为59.5岁。7例患者在卒中发作时没有或只有轻度COVID-19症状。从COVID-19症状到卒中发作的中位时间为6天。所有患者在症状发作后的3个小时内均进行了脑成像检查。5例患者有多部位LVO。5名接受静脉注射阿替普酶治疗。所有患者均进行了机械血栓切除术。9例患者成功实现了再通(mTICI2B-3),无早期神经功能改善,4例患者早期脑血管再闭塞,共有6例患者(60%)在医院内死亡。

由此可见,包括早期静脉溶栓以及通过机械血栓切除术成功再通在内的以往最佳的治疗导致COVID-19患者预后较差。尽管该研究的结果需要进一步证实,但应探究其他药理方法(抗血小板药或其他药),以考虑与COVID-19相关的炎症和凝血功能异常。

原始出处:

Simon Escalard,et al.Treatment of Acute Ischemic Stroke due to Large Vessel Occlusion With COVID-19 Experience From Paris.stroke.2020.https://www.ahajournals.org/toc/str/0/0

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    2021-02-13 kkunny
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    2020-06-01 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!

    0

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