与成年人相比,孩子们的表现如何? 针对急性缺血性中风的血栓切除术后的相对结果进行比较,原因是大血管封闭
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Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
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Matthew C Findlay1, Ramesh Grandhi2, Jayson R Nelson1
1School of Medicine, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, USA.
概括
血管内血栓切除术是一种安全有效的治疗小儿急性缺血性中风,由大血管封闭引起. 这种手术在儿童中显示出高的重血管化率和有利的神经结果,并发症比成年人少.
科学领域:
- 神经学 神经学
- 儿科中风 儿童中风
- 干预性神经辐射学
背景情况:
- 有限的数据存在于内血管血栓切除术 (EVT) 儿科急性缺血性中风 (AIS) 二次大血管封闭 (LVO).
- 与成人结果的比较对于建立儿科治疗指南至关重要.
研究的目的:
- 进行对LVO导致AIS的儿童进行EVT的系统审查和元分析.
- 为了比较EVT在儿童和成人的安全性和有效性结果.
主要方法:
- 系统地搜索PubMed,Medline和EMBASE数据库的儿科研究 (18岁以下的患者) 关于AIS-LVO的EVT.
- 来自8项儿科研究 (n=192) 的数据的元分析和与5项成人临床试验 (n=634) 的比较.
主要成果:
- 在儿童中,高的再通道化率 (88.5%) 和NIH中风量表得分显著降低.
- 儿科患者表现出优异的结果:较高的神经结果率 (76.1%) 和再血管 (88.5%).
- 与成年人相比,儿童的重大周围手术并发症 (3.6%) 和较低的死亡率 (1.0%) 显著减少 (30.4%和12.9%).
结论:
- 血管内血栓切除术是由于LVO引起的儿科AIS的安全有效治疗方法.
- 综合数据显示,高的复血管化率,有利的长期神经结果,和低的儿童并发症率.
- 对于患有AIS-LVO的儿童来说,EVT提供了一个有前途的治疗选择,其结果可能优于成人群体中观察到的结果.
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