Stroke:机械性血栓切除术后实质性血肿的预测因子

2019-07-23 xing.T MedSci原创

由此可见,机械性血栓切除术后PH发生率为11.6%,发病率和死亡率较高。该研究确定了PH发生的临床、影像学和手术预测因子,可以作为未来围手术期管理研究的重点,旨在减少其发生。

实质性血肿(PH)是急性缺血性卒中罕见但可怕的并发症,其潜在机制尚不清楚。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员的目的是探究机械性血栓切除术后PH的发生率和预测因素。 

研究人员筛选了来自前瞻性观察多中心登记处的数据,以确定接受机械血栓切除术的前循环大血管闭塞的急性缺血性卒中患者。临床、成像和手术特征用于分析,包括在24小时进行的脑成像检查。根据ECASS(欧洲协作急性卒中研究)标准评估PH发生率。研究人员进行单变量和多变量分析以确定PH的预测因子。

该研究共纳入1316名患者。1316例患者中有153例(11.6%)发生PH,并且有利结果发生率较低且死亡率增加。在多变量分析,年龄(每增加1岁的比值比[OR]为1.01; 95%CI为1.00-1.03; P=0.05)、目前吸烟(OR为2.02; 95%CI为1.32-3.09; P<0.01)、入院艾伯塔卒中项目早期CT评分(每减少1分的OR为1.70; 95%CI为1.18-2.44; P<0.01)、全身麻醉(OR为1.98; 95%CI为1.36-2.90; P<0.001)、血管造影侧支不良(OR​​为2.13; 95%CI为1.36-3.33; P<0.001)和新区域栓塞(OR为2.94; 95%CI为1.70-5.10; P <0.001)被确定为独立的PH预测因子。 

由此可见,机械性血栓切除术后PH发生率为11.6%,发病率和死亡率较高。该研究确定了PH发生的临床、影像学和手术预测因子,可以作为未来围手术期管理研究的重点,旨在减少其发生。 

原始出处:

William Boisseau.et al.Predictors of Parenchymal Hematoma After Mechanical Thrombectomy A Multicenter Study.stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.024512

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