在儿科莫亚莫亚患者中预防术后中风:一个标准化的术后护理协议
Jennifer Judge1, Ari D Kappel1,2, Christopher Isibor1
1Departments of1Neurosurgery.
Journal of neurosurgery. Pediatrics
|November 17, 2023
概括
在接受莫亚莫亚手术的儿童中,管理恶心和吐的标准化方案显著减少了外科手术前的中风. 这种方法改善了在重血管化程序期间的患者安全.
科学领域:
- 神经外科 神经外科
- 儿科神经学 儿科神经学
- 血管外科 血管外科
背景情况:
- 莫亚莫亚病在重血管化手术期间带来了术后中风的风险.
- 神经外科手术后的恶心和吐可能会导致危险的内压力波动.
研究的目的:
- 评估标准化外科手术期间恶心和吐协议对儿科莫亚莫亚患者中风率的影响,这些患者接受了间接绕道手术.
- 为了确定手术后恶心和吐的积极管理是否会降低手术前中风风险.
主要方法:
- 对接受间接绕道手术的儿科莫亚莫亚患者的回顾性审查.
- 在实施标准化恶心和吐方案之前和之后的31个月中风率的比较.
- 使用费舍尔精确测试来比较中风发病率的统计分析.
主要成果:
- 在协议前和后的队列之间,平均年龄或疾病严重程度没有显著差异.
- 脑卒中发生率从协议实施前的3.6% (5/137个半球) 下降到实施后的0% (0/114个半球) (p=0.065).
- 脑卒中发生率的减少接近统计学意义.
结论:
- 一个标准化的外科手术期间的恶心和吐方案与间接绕道术的moyamoya儿童外科手术期间中风的减少有关.
- 实施这些协议可能会提高儿科神经血管外科手术的安全性.
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