诊断和管理急性中风与新出现的大血管阻塞屏幕
Naoya Imai1, Mitsunori Ishiguro1, Shingo Yonezawa1
1Department of Neurosurgery, Shizuoka City Shizuoka Hospital, Shizuoka, Shizuoka, Japan.
Journal of neuroendovascular therapy
|July 28, 2023
概括
紧急大血管封闭 (ELVO) 屏幕有效地识别了需要内血管治疗 (EVT) 的中风患者,特别是那些心房动患者. 这种医院前的工具可以提高医院内对EVT选择的准确性.
科学领域:
- 神经学 神经学
- 紧急医疗 紧急医疗
- 医学诊断 医学诊断 医学诊断
背景情况:
- 内血管治疗 (EVT) 是主要脑动脉急性阻塞的关键治疗方法.
- 有效的患者选择对于成功的EVT结果至关重要.
- 医院前查工具可以优化紧急护理途径.
研究的目的:
- 评估紧急大血管封闭 (ELVO) 屏幕的有效性,用于急性中风患者的医院分拣.
- 评估ELVO屏幕在识别大血管封闭 (LVO) 中的诊断准确性.
- 确定ELVO屏幕对EVT选择的影响,特别是在心房的患者中.
主要方法:
- 对146例中风病例的回顾性分析,这些病例在中风发作后24小时内进行了检查.
- 对ELVO查结果与已确认的大血管封闭 (LVO) 的评估.
- 分析EVT治疗率和并发症数据,包括心房动.
主要成果:
- 在检测LVO时,ELVO屏幕显示了75%的灵敏度和69%的特异性.
- 在65个阳性ELVO查病例中,51%有LVO;在81个负面病例中,14%有LVO.
- 48%的阳性ELVO屏幕LVO病例使用了EVT,而18%的阴性ELVO屏幕LVO病例使用了EVT.
- 在阳性ELVO查病例中,心房动更常见 (P = 0.001).
- 在阳性ELVO查病例与心房动 (42%,P = 0.02) 中,EVT的频率显著增加.
结论:
- 使用ELVO屏幕进行医院内分组,有助于选择需要EVT的患者.
- 在阳性ELVO查病例中,EVT利用的准确性得到改善,特别是那些心房动病例.
- 在急性中风管理中,ELVO屏幕是优化EVT输送的宝贵工具.
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