在接受非心脏手术的患者中预防术前中风
Maura Marcucci1, Matthew T V Chan2, Eric E Smith3
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamilton, ON, Canada.
The Lancet. Neurology
|September 22, 2023
概括
在非心脏手术后,外科手术期间的中风影响了许多成年人,导致严重残疾或死亡. 识别风险因素和了解术后事件对于预防和改善患者结果至关重要.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 在外科手术期间的医学.
背景情况:
- 非心脏手术很常见,每年有数百万人接受手术.
- 术期中风,虽然发病率低,但影响大量患者,往往导致死亡或严重残疾.
- 隐蔽的脑梗塞比公开的中风更常见,并且与认知问题和未来的脑血管事件有关.
研究的目的:
- 审查关于非心脏手术中的外科手术期间中风风险因素和致病事件的证据.
- 为临床医生强调预防策略的重要性.
- 为了改善非心脏手术后的患者结果.
主要方法:
- 术后中风发病率,风险因素和相关事件的文献综述.
- 对传统中风风险因素和术后并发症的分析.
- 综合关于预防策略的证据.
主要成果:
- 传统的风险因素 (年龄,高血压,心房) 会增加外科手术期间中风的风险.
- 之前的中风是术后中风的最强预测因素.
- 术后事件,如低血压,新的心房动,栓塞和出血,起着重要的病原性作用.
结论:
- 临床医生必须了解术后中风风险和预防策略.
- 了解患者特异性风险因素和手术内事件是关键.
- 有效的管理可以减轻术后中风的严重后果.
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