大动脉管外科手术后的神经和眼科现象
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
概括
对大动脉的管置换和上升大动脉问题可以在50%的患者中引起神经和视觉症状. 这些短暂的事件可以通过抗血小板治疗来管理,提供症状控制.
科学领域:
- 心血管外科心血管外科
- 神经学 神经学
- 眼科医生 眼科 眼科
背景情况:
- 对大动脉和上升大动脉的管置换程序可以导致暂时的神经和视觉障碍.
- 这些术后事件的发生率和性质需要进一步调查.
研究的目的:
- 为了比较管置换后的神经和视觉症状的发生与联合的大动脉置换 (AVR) 和上升大动脉 (AA) 移植置换.
- 评估影响这些事件及其管理的潜在因素.
主要方法:
- 对27名接受管置换的患者和21名接受AVR+AA移植的患者进行了回顾性比较.
- 100%的随访时间为0.3-6.6年 (平均为2.6年),记录神经和视觉事件.
- 分析患者数据,包括药物 (华法林,二胺) 和康复结果.
主要成果:
- 在20名 (50%) 存活的管患者中,有10人经历了重复的神经和视觉症状 (例如,瘤,暂时性缺血性发作).
- 在AVR + AA移植组中,没有患者 (0%) 经历过类似事件 (p = 0.004).
- 虽然大多数患者都在服用华法林,但在某些情况下,二皮里达摩尔显示出对症状控制的潜力.
结论:
- 在管更换后,过渡性,重复性神经和眼科现象很常见.
- 潜在的病理生理机制尚不清楚.
- 抗血小板治疗,如二皮里达摩尔,可以为这些术后事件提供症状缓解.
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