"鼓楼医院"的策略是急性A型大动脉剖析与昏迷
Ya-Peng Wang1, Li-Chong Lu2,3,4,5, Shu-Chun Li2,3,4,5
1Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, Peking Union Medical College Graduate School, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China.
Perfusion
|October 27, 2023
概括
昏迷的急性A型大动脉解剖 (ATAAD) 存在高死亡风险. 一个多式脑评估策略,包括定量脑电图 (qEEG),显示出对管理这些关键病例的希望.
科学领域:
- 心血管外科心血管外科
- 神经学 神经学
- 关键护理医学 关键护理医学
背景情况:
- 持续昏迷的急性A型大动脉解剖 (ATAAD) 是一种具有高死亡率和不良神经结果的危急状况.
- 昏迷的ATAAD的最佳手术时间和治疗策略仍然不确定.
- 由于预后不佳,许多患者被认为无法接受手术.
研究的目的:
- 介绍一个患有ATAAD和持续昏迷的患者的案例研究.
- 评估"鼓楼医院"战略在治疗昏迷的ATAAD中的可行性和潜在有效性.
- 突出多模式大脑评估在指导治疗决策中的作用.
主要方法:
- 一名53岁的高血压男性患者出现了9小时的昏迷状态,并被诊断为ATAAD.
- 使用了"鼓楼医院"的策略,包括计算机断层扫描血管造影 (CTA) 和定量电脑图 (qEEG) 监测.
- 外科干预包括紧急支架和大动脉置换,随后是术后的qEEG监测.
主要成果:
- 术前和术后的qEEG监测表明大脑功能有所改善.
- 患者成功进行了大动脉修复和支架.
- 尽管患有半和神经缺陷,但该策略显示了潜在的好处.
结论:
- "鼓楼医院"战略,结合多式模式大脑评估,为管理昏迷的ATAAD提供了一个潜在的方法.
- 定量脑电图 (qEEG) 监测可以帮助在治疗期间评估大脑功能.
- 进一步的研究是必要的,以建立这个具有挑战性的患者群体的最终治疗方案.
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