大動脈管手術後の神経学的および眼学的現象
P S Peigh1, V J DiSesa, L H Cohn
1Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115.
Circulation
|November 1, 1990
まとめ
大動脈弁の弁管置換と上昇大動脈の問題は,患者の50%で神経学的および視覚的な症状を引き起こす可能性があります. これらの一時的なイベントは,抗血小板療法によって管理され,症状のコントロールが可能です.
科学分野:
- 心血管外科手術についてです.
- 神経学 神経学とは
- オフタルモロジック (眼科)
背景:
- 大動脈弁の弁管置換および上昇大動脈の手続きは,一時的な神経学的および視覚的障害につながる可能性があります.
- これらの術後イベントの発生率と性質については,さらなる調査が必要である.
研究 の 目的:
- 弁管置換後の神経学的および視覚的徴候の発生を,結合大動脈弁置換 (AVR) と昇動大動脈 (AA) 移植置換と比較するために.
- これらのイベントとその管理に影響を与える潜在的な要因を評価する.
主な方法:
- 弁管置換手術を受けた27人の患者と,AVR+AA移植手術を受けた21人の患者との遡及的比較.
- 神経学的および視覚的イベントを記録するために,0.3-6.6年 (平均2.6年) の100%の追跡調査を行った.
- 薬 (ワルファリン,ディピリダモール) とリハビリテーションの結果を含む患者データの分析.
主要な成果:
- バルブ管管患者の生存者20人中10人 (50%) は,繰り返される神経学的および視覚的な徴候 (例えば,スコトマタ,一時的な不血症発作) を経験しました.
- AVR + AA移植群の患者 (0%) は同様のイベントを経験しなかった (p = 0.004).
- ほとんどの患者はワルファリンを服用していましたが,ディピリダモールは一部の症例で症状制御の可能性を示しました.
結論:
- バルブ管置換手術後,一時的な,繰り返される神経学的および眼学的現象は一般的です.
- 根本的な病理生理学的メカニズムは不明である.
- ディピリダモールなどの抗血小板治療は,これらの術後イベントの症状緩和を提供することができます.
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