急性中风干预:系统性审查
Shyam Prabhakaran1, Ilana Ruff1, Richard A Bernstein1
1Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
JAMA
|April 15, 2015
概括
急性缺血性中风治疗改善了靠近脉封闭的机械血栓切除术. 早期输血,包括静脉输血栓溶解和血栓切除术,是改善患者结果的关键.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 神经外科 神经外科
背景情况:
- 急性缺血性中风是美国死亡和残疾的主要原因.
- 及时的再输血对于改善患者的治疗结果至关重要.
研究的目的:
- 审查急性脑缺血和心脏病发作的病理生理学.
- 评估各种中风再注射治疗的证据,包括静脉血栓溶解和机械血栓切除术.
主要方法:
- 在MEDLINE (1990-2015) 的系统文献搜索.
- 包括随机试验,观察性研究,指南和评论.
- 分析了68篇文章,涵盖了108,082名患者.
主要成果:
- 静脉血栓溶解 (IV rtPA) 是符合条件的患者在4.5小时内进行的标准.
- 机械血栓切除术显著改善了近端动脉封闭症的选择患者的结果.
- 通过任何方法,更早的再输血与更好的临床结果相关.
结论:
- 静脉rtPA仍然是4.5小时内急性缺血性中风的标准护理.
- 内血管治疗为特定患有近端动脉封闭症的患者提供了更好的结果.
- 通过有组织的中风系统加速再注射治疗是必不可少的.
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