Int J Cardiol:术前全身CT扫描与微创二尖瓣手术中卒中风险降低相关

2018-12-13 xing.T MedSci原创

由此可见,术前全身CT筛查与较低的术后卒中风险和透析需求以及MIMVS后手术死亡率降低的趋势相关。

微创二尖瓣手术(MIMVS)在临床进行的频率越来越高。然而,接受MIMVS治疗的患者围手术期卒中的风险可能增加,这主要是由于股动脉-心肺转流术中逆行主动脉栓塞所致。术前计算机断层扫描(CT)筛查可做到主动脉和股髂血管的可视化和手术方法的个性化。近日,血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,在这项荟萃分析中,研究人员的目标是确定全身性术前CT筛查是否与MIMVS术后卒中和其他并发症发生率降低有关。

研究人员对PubMed(从成立至2018年5月)进行了全面的审查。符合条件的研究包括报告MIMVS和逆行动脉灌注的研究。研究分为两个亚组:全身术前CT筛查(CT组)和无CT筛查(非CT)。研究人员评估了手术死亡、术后卒中、围手术期心肌梗死(MI)和需要透析的新发肾衰竭汇总事件发生率(PER),并进行组间比较。

研究人员分析了来自57项研究(13731名患者)的数据(19个CT组,38个非CT组)。术后卒中的PER为2.0%,两组间差异具有统计学意义(CT组:1.5% vs. 非CT组:2.2%,P=0.03)。新透析的PER为1.9%,在CT组显著降低(0.8% vs. 非CT组为2.3%,P=0.02)。手术死亡率的PER为1.4%,CT组的结局趋势更好(非CT组为0.8% vs. 1.6%,P=0.05)。

由此可见,术前全身CT筛查与较低的术后卒中风险和透析需求以及MIMVS后手术死亡率降低的趋势相关。

原始出处:


Jeremy R.Leonard,et al.Systematic preoperative CT scan is associated with reduced risk of stroke in minimally invasive mitral valve surgery: A meta-analysis.International Journal of Cardiology.2018.https://doi.org/10.1016/j.ijcard.2018.12.025

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    2018-12-15 vera_1203
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    2018-12-15 wwzzly
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    2018-12-13 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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    2018-12-13 guging

    中风是俗称,应该称为缺血性卒中吧

    0

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