患有莫亚莫亚动脉病变的儿科患者的周术管理
Sarah E Gardner Yelton1, Monica A Williams1, Mollie Young2
1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States.
Journal of pediatric intensive care
|August 11, 2023
概括
这项研究概述了一种新的护理途径,用于在手术期间减少儿科莫亚米亚动脉病患者的神经学缺陷. 目标是尽量减少这些高风险儿童中风和暂时性缺血性发作 (TIA) 的风险.
科学领域:
- 神经学 神经学
- 儿科重症监护 儿科重症监护
- 麻醉学 麻醉学
背景情况:
- 莫亚莫亚动脉病变对儿科患者造成显著的外科手术期神经学风险,包括中风和暂时性缺血性攻击 (TIA).
- 有限的研究存在于管理这些患者,特别是在重症监护室 (ICU) 停留后麻醉.
- 大脑的低输液是主要问题,需要仔细的外科手术管理.
研究的目的:
- 开发一个多学科的,基于证据和共识的周围手术护理途径,用于患有莫亚莫亚动脉病的儿科患者.
- 为了减少新的永久的神经缺陷,中风或TIA在高风险的儿科莫亚莫亚患者进行麻醉的发生率.
- 标准化和改进这些脆弱患者的术后管理.
主要方法:
- 文献综述,以确定围绕手术的中风/TIA风险因素以及莫亚莫亚患者的管理策略.
- 组建一个多学科团队,包括麻醉,神经临床护理,护理,儿童生活,神经外科,干预神经放射学,神经学和血液学.
- 制定护理途径,将患者分为高风险或标准风险类别,并为高风险病例制定个性化计划.
主要成果:
- 为接受麻醉的儿科莫亚莫亚患者创建了一条综合护理途径.
- 该途径对风险进行分层,并为高风险患者提供个性化管理计划.
- 未来的研究将比较在途径实施之前和之后的神经系统序列发生率.
结论:
- 多学科的护理途径对于治疗儿科莫亚动脉病患者的外科治疗至关重要.
- 这一途径旨在减轻这种高风险人群中神经系统缺陷,中风和TIA的风险.
- 标准化护理途径可以改善莫亚莫亚儿童接受麻醉的结果.
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