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在急性A型大动脉剖析手术中保护大脑:系统性审查和元分析

Mehran Rahimi¹, Hadi Sahrai², Ali Norouzi²

¹Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Journal of thoracic disease

|March 20, 2024

概括

前级大脑输液 (ACP) 和逆向大脑输液 (RCP) 在急性A型大动脉剖析 (ATAAD) 手术中是安全的. 单边ACP (uACP) 在神经功能障碍和死亡率方面与双边ACP (bACP) 相似,但uACP在过渡性神经缺陷方面表现更好.

科学领域:

心血管外科心血管外科
神经学神经学
医疗技术医疗技术医学技术

背景情况:

急性A型大动脉解剖 (ATAAD) 带来了重大的外科手术挑战.
脑血管事件是ATAAD手术期间的主要关注点.
前级脑输液 (ACP) 和逆向脑输液 (RCP) 是缓解这些风险的关键技术.

研究的目的:

系统地审查和比较ATAAD手术中ACP和RCP方法的结果.
评估单边ACP (uACP) 与双边ACP (bACP) 的有效性.

主要方法:

在ATAAD手术中比较ACP和RCP的研究的系统审查和元分析.
搜索数据库至2023年3月29日,包括26项涉及13039名患者的研究.
使用Joanna Briggs Institute (JBI) 批判性评估工具评估偏见的风险.

主要成果:

在ACP和RCP之间,永久神经功能障碍 (PND) 没有显著差异 (RR=1.23,P=0.2662).
在uACP和bACP之间没有显著的PND差异 (RR=1.2786,P=0.3132).
暂时神经缺陷 (TND) 优于uACP而不是bACP的显著差异 (RR=1.32,P=0.0199).

结论:

在新兴的ATAAD手术中,ACP和RCP都是安全和可接受的 perfusion 技术.
单边的ACP (uACP) 相当于双边的ACP (bACP) 在PND和死亡率方面.
由于TND的发病率较低,uACP比bACP更受欢迎.

关键词:

剖析剖析分解上升的大动脉上升心脏外科手术手术的过程.心肺绕道 (CPB) 是一种心肺绕道.神经系统表现神经系统表现

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