创伤后血管的治疗干预后的结果:系统性审查和元分析
Katherine Riordan1, James Mamaril-Davis1, Pedro Aguilar-Salinas2
1College of Medicine, University of Arizona College of Medicine - Tucson, Tucson, AZ, United States.
Clinical neurology and neurosurgery
|July 13, 2023
概括
针对创伤后血管 (PTV) 的量身定制治疗改善了患者的治疗结果. 内血管干预显示出最高的成功率,而通道阻断剂和多巴胺诱导的高血压具有相似的,较低的率.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 关键护理医学 关键护理医学
背景情况:
- 创伤后血管 (PTV) 可以对创伤性脑损伤后的恢复产生负面影响.
- 基于证据的PTV治疗指南是有限的.
- 这项研究系统地审查了PTV治疗的结果.
研究的目的:
- 评估不同PTV治疗方法的有效性.
- 通过使用格拉斯哥结果尺度 (GOS) 评分来评估有利的结果.
- 综合目前关于PTV管理的证据.
主要方法:
- 对PubMed,Ovid MEDLINE和Ovid EMBASE进行系统审查.
- 对14项涉及1885名PTV患者的研究进行了分析.
- 随机效应元分析,比较通道阻断剂 (CCB),内血管干预和多巴胺诱导的高血压的结果.
主要成果:
- 针对PTV的量身定制治疗干预改善了有利结果率 (57.7%) 与没有量身定制治疗 (52.0%) 相比.
- 内血管干预显示出最高的有利结果率 (94.1%),尽管样本规模小 (n=17).
- 通道阻塞剂 (57.3%) 和多巴胺诱导的高血压 (54.8%) 显示出类似的,较低的有利结果率.
结论:
- 针对PTV的量身定制的治疗干预与有利的患者结果有关.
- 血管内干预似乎对PTV最有效,但需要对更大的队列进行进一步的研究.
- CCB和多巴胺诱导的高血压提供了具有中等成功率的替代治疗选择.
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