对于具有大缺血核心的急性中风的内血管血栓切除术:随机对照试验的系统审查和元分析
Mohamed Abuelazm1, Unaiza Ahmad2, Husam Abu Suilik3
1Faculty of Medicine, Tanta University, Tanta, Egypt.
Clinical neuroradiology
|May 26, 2023
概括
血管内血栓切除术 (ET) 改善了中风患者具有大缺血核心的功能独立性,但增加了内出血的风险. 这表明,尽管存在潜在的并发症,ET可能是有益的.
科学领域:
- 神经学 神经学
- 干预心脏病学 干预心脏病学
- 公共卫生 公共卫生
背景情况:
- 血管内血栓切除术 (ET) 对大缺血核心中风的有效性仍然不清楚,因为在试验中代表人数不足.
- 这项研究通过分析现有的随机对照试验 (RCT) 来解决这一差距.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT),评估大缺血核心中风患者的ET.
- 评估ET对神经障碍和功能结果的影响.
主要方法:
- 从PubMed,科学网络,SCOPUS和Cochrane数据库中获取的RCT的系统审查和元分析,截至2023年2月18日.
- 主要结局:通过修改的兰金尺度 (mRS) 测量的神经障碍.
- 使用风险比率 (RR) 和置信区间 (CI) 的二分法结果与Revman V.5.4软件.
主要成果:
- 对1010名患者进行的3项RCT的分析显示,ET显著增加了功能独立性 (mRS ≤ 2,RR: 2.54) 和独立行走 (mRS ≤ 3,RR: 1.78).
- ET还改善了早期的神经改善 (RR: 2.46) 并减少了神经恢复不良 (mRS 4-6,RR: 0.79).
- 没有观察到出色的神经恢复的显著差异 (mRS ≤1,RR: 1.35),但ET与较高的内出血率有关 (RR: 2.40).
结论:
- 与医疗护理相结合的内血管血栓切除术显示,与单独的医疗护理相比,对于患有大缺血核心的中风患者,功能结果有所改善.
- 尽管内出血的发病率较高,但ET的好处支持在这个患者群体中扩大其使用.
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