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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

  9. [GetPortalCommentsPageByObjectIdResponse(id=1820681, encodeId=cca1182068100, content=<a href='/topic/show?id=0c6a1009105e' target=_blank style='color:#2F92EE;'>#风险降低#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100910, encryptionId=0c6a1009105e, topicName=风险降低)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd18451, createdName=xre2008, createdTime=Thu Jan 03 22:34:00 CST 2019, time=2019-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1781986, encodeId=3dc91e81986b8, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Oct 16 07:34:00 CST 2019, time=2019-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1952155, encodeId=e6cd1952155f2, content=<a href='/topic/show?id=f11b2390577' target=_blank style='color:#2F92EE;'>#二尖瓣手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23905, encryptionId=f11b2390577, topicName=二尖瓣手术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5a6b240, createdName=俅侠, createdTime=Sat Sep 28 22:34:00 CST 2019, time=2019-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281297, encodeId=feab128129e01, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Sat Dec 15 07:34:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317042, encodeId=5070131e042f9, content=<a href='/topic/show?id=df8950505a2' target=_blank style='color:#2F92EE;'>#微创#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50505, encryptionId=df8950505a2, topicName=微创)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Sat Dec 15 07:34:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463221, encodeId=a92f146322166, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Sat Dec 15 07:34:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618768, encodeId=517d1618e68fe, content=<a href='/topic/show?id=aa2e5463db' target=_blank style='color:#2F92EE;'>#CT扫描#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5463, encryptionId=aa2e5463db, topicName=CT扫描)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ed3819951332, createdName=ms6323715314570549, createdTime=Sat Dec 15 07:34:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026234, encodeId=d5531026234de, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Thu Dec 13 19:34:00 CST 2018, time=2018-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045822, encodeId=e176104582246, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Dec 13 19:34:00 CST 2018, time=2018-12-13, status=1, ipAttribution=)]
    2018-12-13 guging

    中风是俗称,应该称为缺血性卒中吧

    0

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