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在急性A型大动脉剖析中术后中风:发生率,结果和术后风险因素
Kasana Raksamani1, Manisa Tangvipattanapong1, Napat Charoenpithakwong1
1Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand.
BMC surgery
|July 25, 2024
概括
急性A型大动脉解剖 (ATAAD) 修复后的中风很常见,并增加了住院时间. 关键风险包括虚弱,低血压和脑氧和度降低,突出了针对性干预的必要性.
科学领域:
- 心血管外科心血管外科
- 神经学 神经学
- 麻醉学 麻醉学
背景情况:
- 急性A型大动脉解剖 (ATAAD) 修复后中风发生率仍然很高,导致不良结果.
- 管理ATAAD涉及复杂的术后护理,需要解决可修改的患者因素和麻醉策略.
研究的目的:
- 为了确定在ATAAD手术后中风的发生率和后果.
- 为了确定在ATAAD患者中发生中风的术后风险因素.
主要方法:
- 对516名ATAAD手术患者的多中心回顾分析.
- 对人口,临床,外科和结果数据的评估.
- 主要终点:术后中风发生率;次要终点:死亡率和并发症.
主要成果:
- 术后中风发生在13.6%的患者中,显著延长了ICU和住院时间.
- 确定了独立的中风风险因素:高修饰性虚弱指数 (mFI) (≥4),常见的动脉缺血,CPB前低血压,手术内脑rSO2降低 (≥20%),以及CPB后升高的血管活性-异位积分 (VIS) (≥10).
结论:
- 术后中风在ATAAD患者中大大延长了ICU和住院时间.
- 缓解高MFI,不输血,低血压,大脑脱和高VIS等风险对于改善结果和降低中风患病率至关重要.
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