在全身麻醉下进行机械血栓切除术时的动脉低血压"大小"和神经结果
Vincent L'Allinec1, Madjid Bouizegarene2, Océane Palka1
1Department of Radiology, University Hospital of Angers, Angers 49100, France.
概括
在急性缺血性中风 (AIS) 机械血栓切除术 (MT) 期间的低血压与不良结果有关. 该研究量化了低血压大小,显示了它.
科学领域:
- 神经学 神经学
- 干预心脏病学 干预心脏病学
- 关键护理医学 关键护理医学
背景情况:
- 机械血栓切除术 (MT) 是急性缺血性中风 (AIS) 与大血管封闭 (LVO) 的标准.
- 在MT之后的不良结果是常见的.
- 手术性动脉低血压是一种已知的危险因素,导致患者的治疗结果不佳.
研究的目的:
- 评估在MT期间动脉低血压大小对神经结果的影响.
- 通过低血压发作的深度和持续时间来定义低血压大小.
- 为了研究低血压和MT后的神经缺陷之间的关联.
主要方法:
- 在全身麻醉下为前部LVO接受MT的患者的单心回顾性研究 (2018年1月 - 2021年6月).
- 平均动脉压 (MAP) 每5分钟记录一次.
- 使用曲线下的面积 (AUC) 来量化低血压的大小,用于各种MAP下降值 (5-30%).
主要成果:
- 在117名分析患者中,有46%的患者经历了不良的神经结果.
- 较大的程序性低血压大小 (AUC) 与所有测试的MAP下降值 (5-30%,P ≤0.011) 的不良结果相关.
- 在对年龄,NIHSS和ASPECT分数进行调整后,这种关联仍然显著.
结论:
- 在AIS的MT期间低血压的幅度是90天神经学结果差的独立预测指标.
- 这一发现适用于轻度和严重的低血压发作.
- 在MT期间最大限度地降低血压可能会改善患者的治疗结果.
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