在急性缺血性中风的内血管治疗期间,在外科手术期间,未分离的肝素大肠注射剂会比有益的伤害更多
Johannes Wischmann1, Ilias Masouris2, Linus Keidel2
1Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany johannes.wischmann@med.uni-muenchen.de.
Journal of neurointerventional surgery
|September 4, 2023
概括
在中风的内血管治疗期间,未分离的氨酸 (UFH) 玻尿酸可能会增加并发症. 现实数据证实UFH没有益处,并且可能有害,特别是在接受静脉输血栓溶解的患者中.
科学领域:
- 神经学 神经学
- 干预神经病学 干预神经病学
- 血管神经学 血管神经学
背景情况:
- 在急性缺血性中风的内血管治疗 (EVT) 中,有时使用未分离的氨酸 (UFH),以防止凝块.
- MR CLEAN-MED试验表明,UFH可能会增加症状性内出血 (sICH) 和恶化功能结果.
研究的目的:
- 评估前 (ACS) 和后循环中风 (PCS) 患者进行EVT的外围手术UFH玻尿酸对现实世界的影响.
- 评估UFH玻尿酸在这些患者群体中是否提供净益处或增加风险.
主要方法:
- 德国中风登记-内血管治疗数据库的分析.
- 倾向性得分匹配用于比较UFH和非UFH组之间的结果.
- 主要结局在3个月后修改了兰金尺度;次要结局包括死亡率和出血.
主要成果:
- 在倾向性得分匹配的患者中,UFH胆固醇与更糟糕的功能结果有关,与MR CLEAN-MED的发现保持一致.
- 在所有前后循环中风患者中,UFH胆固醇没有显示出净益.
- 对于接受静脉输血栓溶解 (IVT) 的 ACS 患者来说,UFH 囊剂的使用与较差的功能结果显著相关.
结论:
- MR CLEAN-MED试验结果可转移到现实实践中,这表明周围手术UFH对功能结果的负面影响.
- 在ACS和PCS患者中,周围手术UFH没有提供净益处,而且似乎有害.
- 在中风患者中,UFH玻尿酸特别有害,这些患者也接受了IVT治疗.
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