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Can Med Assoc J:没有早期并发症的中风康复后就高枕无忧了吗?

2017-07-24 sunshine2015 来宝网

幸存于脑卒中或微创中风而没有早期并发症的人在最初中风后至少5年内有增加的死亡风险及再一次中风或心脏病发作(心肌梗塞)的风险。



没有早期并发症的中风幸存者存在长期的死亡和中风风险】幸存于脑卒中或微创中风而没有早期并发症的人在最初中风后至少5年内有增加的死亡风险及再一次中风或心脏病发作(心肌梗塞)的风险。

资深作者,多伦多Sunnybrook健康科学中心神经病学家Richard Swartz博士说:“在轻度初次事件发生后的几年中,真正需要保持长期的风险降低策略,医疗支持和健康的生活方式选择。”

许多研究表明随着时间的推移风险升高,尽管大多数患者在90天早期高风险期间包括并发症患者,而不是中风或短暂性脑缺血发作(TIA)后期并发症的幸存者。

TIA后中风的风险在前90天最高,但这项研究表明,即使经过多年的稳定,仍然存在危险性增加的风险。

“这些分析表明,中风和TIA之后的生存是长期风险的标志,值得高度重视风险降低策略,”作者写道。

该研究包括2003年7月至2013年3月期间在安大略省区域性卒中中心的前90天内卒中或TIA未出现并发症的26 366例患者,以及263 660例匹配对照组。研究人员发现,在与卒中后并发症相关的患者组中,与对照相比,长期并发症的风险明显高于对照组。 1年时,9.5%的人发生死亡,中风,心脏病发作或长期护理等不良事件,3年时为23.6%,5年为35.7%。

Swartz博士说:“这些研究结果突出表明,需要长期管理可变风险,例如高血压,监测和治疗不规则的心律,戒烟和身体锻炼。”

长期风险降低的其他选择可能包括为中风幸存者定制现有的心脏康复计划,患者多于卒中或TIA后几个月,并将长期管理纳入初级保健实践。

作者总结道:“对于中风或TIA的幸存者来说,中风复发的长期风险特别高,表明中风复发是最重要的可改变的结果。”

在相关评论中,卡尔加里大学的迈克尔·希尔博士写道:“中风被认为是一个主要的公共卫生问题,不正确地被认为是一种仅影响老年人的疾病,在北美和西欧,中风总体而言,是第三或第四大死因,但在发展中国家是第一或第二,取决于国家。

我们必须专注于减少复发性中风和死亡,改善中风后治疗和长期随访。

原始出处:

Jodi D. Edwards et al. Long-term morbidity and mortality in patients without early complications after stroke or transient ischemic attack, Canadian Medical Association Journal (2017). DOI: 10.1503/cmaj.161142.

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    2017-12-27 丁鹏鹏
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    2017-07-29 QQ25ed180f

    中风,越来越年轻化了

    0

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    2017-07-25 130****4638

    学习了受益匪浅

    0

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    2017-07-24 桂杉

    学习,不错不错

    0

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    2017-07-24 中医痴

    不错的,学习了,谢谢分享!

    0

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    2017-07-24 衣带渐宽

    学习

    0

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