在患有左侧传染性内心炎和中风的患者中,早期 vs 延迟手术
Jamila Kremer1, Joshua Jahn1, Sabrina Klein2
1Department of Cardiac Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany.
Journal of cardiovascular development and disease
|August 25, 2023
概括
感染性内心炎和中风的早期手术是安全的. 接受早期门手术 (0-7天) 的患者表现与延迟手术患者相似,包括生存和神经恢复.
科学领域:
- 心脏病学 心脏病学
- 神经外科 神经外科
- 传染性疾病 传染性疾病
背景情况:
- 在感染性内心炎和并发性中风患者手术干预的最佳时间被争论.
- 目前的指导方针通常建议将手术推迟长达四周.
- 然而,在早期心力衰竭或复发性败血栓塞的情况下,可能需要紧急手术.
研究的目的:
- 评估感染性内心炎和手术前神经事件的患者早期与延迟的门手术的安全性和结果.
- 为了确定早期手术干预是否与不良的神经学或死亡结果有关.
主要方法:
- 对688名因左侧感染性内心炎进行手术治疗的患者进行了回顾性分析.
- 确定了187名患有手术前神经事件的患者,147人记录了中风发作.
- 患者被分为早期手术组 (0-7天) 和延迟手术组 (>7天). 术后神经状态使用修改的兰金度量表进行评估.
主要成果:
- 在患有神经复杂症的患者中,术前败血症更为常见 (46.0%与29.5%相比).
- 患有出血性中风的患者更有可能接受延迟手术 (19.8%对3.3%).
- 术后脑血管事故,神经结果和康复率在早期和晚期手术组之间是可比的. 住院死亡率和长期存活率没有显著差异.
结论:
- 在患有传染性内心炎和中风的高风险患者中,早期的门手术是一种安全和可行的选择.
- 在中风发作后7天内进行手术与延迟手术相比,并没有与更糟糕的神经结果或生存相关.
关键词:
大动脉门的大动脉门大脑栓塞 (脑栓塞) 是一种脑栓塞.心脏衰竭是因为心脏衰竭.传染性内心炎 (IE) 是一种感染性内心炎.内出血 内出血神经系统并发症 神经系统并发症一次性中风中风中风中风中风外科手术的时间.门外科手术 门外科手术更多相关视频
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