手术后心房的管理 (POAF):一个系统的审查
Dakshin Meenashi Sundaram1, Advait M Vasavada2, Chetna Ravindra3
1Internal Medicine, ESIC Medical College and PGIMSR, Chennai, IND.
Cureus
|September 4, 2023
概括
手术后心房动 (POAF) 的管理有所不同. 对于三天内无症状病例,节律控制是足够的,而节律控制则用于并发症. 抗凝血的风险和益处取决于手术类型和POAF持续时间.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 基于证据的医学基于证据的医学.
背景情况:
- 手术后心房动 (POAF) 是手术后的一个常见并发症.
- POAF增加了死亡率和血栓栓塞栓事件的风险.
- 对于POAF的最佳管理策略仍然不清楚.
研究的目的:
- 系统地审查POAF目前的治疗和管理方法.
- 评估各种POAF干预措施的有效性,适宜性和副作用.
- 为了确定POAF的临床实践指南中的差距.
主要方法:
- 对2018年至2023年间发表的研究进行系统审查.
- 在谷歌学者和PubMed数据库中搜索相关文章.
- 包括10项研究,涵盖293417个POAF病例.
主要成果:
- 在手术后1-3天内,对于无症状的POAF来说,节律控制是足够的;节律控制是为血液动力学不稳定性保留的.
- 抗凝药通常用于POAF超过四天后手术.
- 在CABG后,抗凝血药物显示增加了风险 (死亡率,中风,出血),但在其他POAF病例中改善了结果.
结论:
- 对POAF存在多种管理方法,但临床证据有限.
- 目前的数据很大程度上是追溯的,不足以进行最终的疗效评估.
- 需要对POAF进行标准化治疗方案,需要进一步研究.
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