在法国,怀孕期间和产后缺血性中风的急性再血管化疗法
Yannick Béjot1, Valérie Olié2, Grégory Lailler2
1Dijon Stroke Registry, Department of Neurology, University Hospital of Dijon, EA7460, Pathophysiology and Epidemiology of Cardio-Cerebrovascular Disease (PEC2), University of Burgundy, Dijon, France.
European stroke journal
|May 26, 2023
概括
在孕妇或产后妇女的缺血性中风 (IS) 中,急性再血管治疗是安全有效的,其结果与非孕妇相似. 这些发现支持目前在怀孕期间和分娩后治疗IS的指导方针.
科学领域:
- 神经学 神经学
- 产科和妇科 产科和妇科
- 血管医学 血管医学
背景情况:
- 怀孕期间和产后的缺血性中风 (IS) 对急性复血管治疗提出了独特的挑战.
- 指导方针建议进一步证实静脉血栓溶解 (IVT) 和机械血栓切除 (MT) 在这个人群中的有效性和安全性.
研究的目的:
- 为了比较孕妇/产后妇女的特征,治疗率和结果,IS接受急性再血管治疗与非孕妇相比.
- 为了评估没有接受急性再血管化治疗的IS孕妇的结果.
主要方法:
- 一项使用法国医院出院数据库 (2012-2018) 的横截面研究.
- 鉴定了因IS住院的15-49岁妇女,区分与怀孕相关的病例 (包括产后至6周).
- 收集有关患者特征,风险因素,再血管化疗法,分娩,存活率和复发性血管事件的数据.
主要成果:
- 在382名患有IS的孕妇/产后妇女中,7.3%接受了再血管化治疗,与8.5%的非孕妇相似.
- 接受治疗的孕妇/产后妇女患上更严重的IS,但年轻;其他特征和中风严重程度与接受治疗的非孕妇相似.
- 在接受治疗的孕妇/产后妇女和非孕妇之间,没有观察到出血率或住院时间的显著差异. 所有接受治疗的孕妇都有活产,所有产后妇女都存活了,复发率很低.
结论:
- 在孕妇和产后妇女中,IS的急性再血管治疗的应用率与非孕妇相似.
- 包括存活率和复发事件风险在内的结果在接受治疗的孕妇/产后和非孕妇之间是可比的.
- 研究结果支持不论怀孕状态如何,应用IS治疗策略,与最近的指导方针保持一致.
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