JAMA:麻醉方式与脑卒中溶栓术患者神经功能预后

2019-10-02 MedSci MedSci原创

在前循环急性缺血性脑卒中溶栓术中接受全身麻醉不会增加患者3个月的神经预后风险

在非随机研究中,急性缺血性脑卒中患者血栓切除术期间全麻与不良神经预后有关,但三个单中心随机试验称,与程序镇静相比,接受全身麻醉的患者预后没有明显的差异。近日研究人员比较了前循环急性缺血性脑卒中溶栓术中全麻与程序镇静术后3个月功能结局差异。

本次研究为系统综述及荟萃分析研究,收集截至2019年7月31日的相关资料。研究的主要终点为残疾程度,通过修正的Rankin (mRS)评分(0-6;较低的分数表示较少的残疾)。

总计368名参与者,平均年龄71.5岁,女性44.3%,平均NIHSS得分为17,包含183名全麻患者(49.7%)以及185名程序镇静患者(50.3%)。全麻患者3个月 mRS得分为2.8,程序镇静为3.2,OR=1.58。在预先设定的不良事件中,仅血压过低(较基线低20%,80.8% vs 53.1%)以及血压波动(动脉压>180 或<120 mm Hg,79.7 vs 62.3%)事件的发生率在全麻组偏高。

研究认为,在前循环急性缺血性脑卒中溶栓术中接受全身麻醉不会增加患者3个月的神经预后风险。

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    2019-10-02 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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