血管内血栓切除术后急性缺血性中风患者的血压目标:一个元分析
Yitao Zhou1, Zixi Chen2, Jinyan Fang2
1School of Nursing, Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China.
Clinical neurology and neurosurgery
|June 24, 2023
概括
在急性缺血性中风 (AIS) 内血管治疗后进行密集的血压管理可以改善结果. 向静脉压 (SBP) 在140mmHg以下显示出对再输和减少并发症的最大益处.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 干预性放射学 干预性放射学
背景情况:
- 急性缺血性中风 (AIS) 管理需要优化输血后内血管治疗 (EVT).
- 后EVT血压目标显著影响临床结果,包括安全性和有效性.
- 了解最佳血压水平对于改善患者康复至关重要.
研究的目的:
- 评估EVT后不同血压水平对AIS患者结局的影响.
- 评估安全性和疗效指标,包括功能恢复,死亡率和并发症.
- 确定最佳的血压目标,以改善患者管理.
主要方法:
- 对2023年2月1日之前发表的研究进行系统的元分析.
- 在PubMed,Embase,Cochrane图书馆和科学网上进行的搜索.
- 主要结局包括90天修改的兰金尺度 (mRs) 评分,死亡率,症状性内出血 (sICH) 和脑膜切除术.
主要成果:
- 在不同血压水平的90天mRs0-2分数中没有显著差异.
- 亚组分析显示了mRs得分的显著差异,SBP<140 mmHg.
- SBP < 140 mmHg 与统计学上显著减少sICH和脑膜切除术发生率有关.
结论:
- 密集的血压管理,特别是针对SBP<140 mmHg,有助于在接受EVT的AIS患者中成功实现再注血.
- 将SBP降低到140mmHg以下似乎为患者带来了最大的临床益处,减少了sICH等并发症和脑膜切除术的需要.
- 这些发现提供了一个关键的血压目标,以告知未来在AIS管理中的大规模随机对照试验的设计.
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