急性脳卒中介入:体系的なレビュー
Shyam Prabhakaran1, Ilana Ruff1, Richard A Bernstein1
1Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
JAMA
|April 15, 2015
まとめ
急性不全性脳卒中治療は,近接動脈閉塞に対する機械的血栓切除で改善されました. 静脈内血栓溶解および血栓切除を含む早期再注血は,より良い患者のアウトカムのための鍵です.
科学分野:
- 神経学 神経学とは
- 心血管医学は,心臓血管医学である.
- 神経外科は神経外科です.
背景:
- 急性不全性脳卒中は,米国における死亡と障害の主な原因である.
- 患者のアウトカムを改善するために,タイムリーな再注血は不可欠です.
研究 の 目的:
- 急性脳缺血と心臓発作の病理生理学をレビューする.
- 静脈内血栓溶解および機械的血栓切除を含む様々な脳卒中再注射治療の証拠を評価する.
主な方法:
- MEDLINE (1990-2015) の体系的な文献検索について
- ランダム化試験,観察研究,ガイドライン,レビューを含む.
- 108,082人の患者を対象とした68件の論文を分析した.
主要な成果:
- 静脈内血栓溶解 (IV rtPA) は,適格な患者にとって4.5時間以内の標準です.
- 機械的血栓切除術は,近親動脈閉塞の選択された患者のアウトカムを大幅に改善します.
- どの方法であれ,早めの再注血は,より良い臨床結果と相関しています.
結論:
- IVrtPAは,4.5時間以内の急性性不血性脳卒中の標準的なケアとなっています.
- 血管内部の治療は,近親動脈閉塞の特定の患者にとって改善された結果を提供します.
- 組織的な脳卒中システムを介して再注射療法を加速することは不可欠です.
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