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在后循环中缺血性中风的静脉内血栓溶解:系统性审查和元分析
Robrecht R M M Knapen1, Senta Frol2, Sander M J van Kuijk3
1Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ and CARIM, School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
概括
对于后部循环中风 (PCS) 的静脉内血栓溶解 (IVT) 显示了有利的结果. 与延长时间窗口相比,标准时间窗口治疗显著改善功能结果并降低死亡率.
科学领域:
- 神经学 神经学
- 心血管疾病 心血管疾病
背景情况:
- 后部循环中风 (PCS) 往往导致不良的神经结果没有治疗.
- 内静脉血栓溶解 (IVT) 是前后循环中缺血性中风的推治疗方法.
研究的目的:
- 对PCS患者IVT的结果进行系统审查和元分析.
- 为了比较IVT在标准 (<4.5小时) 和延长 (>4.5小时) 时间窗口内对PCS的有效性.
主要方法:
- 进行了系统的文献搜索,截至2023年2月27日.
- 包括的研究被分析为有利的功能结果 (修改的兰金尺度0-2),90天死亡率和症状内出血 (sICH).
- 用加权平均值分析数据,根据治疗时间窗口进行子组分析.
主要成果:
- 分析包括来自12项队列研究的1589名患者;没有对保守治疗的研究符合条件.
- 在PCS中IVT的聚合概率是:63%的良好结果,19%的死亡率和4%的SICH.
- 与延长时间窗口 (38%) 相比,在标准时间窗口 (<4.5小时) 中接受治疗的患者显示出明显更高的良好结果 (77%) 和较低的死亡率和SICH率.
结论:
- IVT是PCS在标准和延长时间窗口中安全有效的治疗方法.
- 当在标准时间窗口内进行IVT治疗时,对PCS的疗效明显更高.
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