手术前的内出血是否是中风感染性内心炎的手术禁忌?
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Updated: Jul 12, 2025

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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
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June Lee1, Hyun Ah Lim1, Seok Beom Hong1
1Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Journal of thoracic disease
|October 23, 2023
概括
对于传染性内心炎 (IE) 和中风,手术前的内出血 (ICH) 不会恶化手术结果. 开放心脏手术是安全的,在患有或没有手术前ICH的患者中存在类似的出血和死亡风险.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 神经外科 神经外科
背景情况:
- 决定感染性内心炎 (IE) 与中风的手术时间是具有挑战性的,因为可能加剧神经学缺陷和内出血转换的风险.
- 心肺旁路 (CPB) 在手术中IE中风带来风险,特别是关于手术前内出血 (ICH).
研究的目的:
- 研究术前内出血 (ICH) 对感染性内心炎 (IE) 和最近中风患者手术结果的影响.
主要方法:
- 对164名接受活跃IE开放心脏手术的患者的回顾性审查 (2009年2月至2020年12月).
- 对71名患有左侧IE和中风在手术后4周内发作的患者的分析,分为 (n=22) 和没有 (n=49) 手术前ICH的组.
主要成果:
- 两组间手术后ICH发生率没有显著差异 (10.2%对13.6%,P=0.696).
- 在不同组之间,30天死亡率 (8.2%对4.5%,P=1.000) 和一年生存率 (86.8%对95.5%,P=0.320) 相似.
- 没有确定的风险因素会导致手术后的ICH恶化.
结论:
- 手术前的ICH不会增加近期败血性脑栓塞的IE患者在心脏开放手术后术后ICH恶化的风险.
- 在接受开放心脏手术的手术前ICH的IE患者中,早期死亡率并不高.
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