在急性栓塞性中风后,内心炎的早期门手术
Kareem Wasef1, Taylor D'etcheverry1, J W Awori Hayanga1
1Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia.
The Annals of thoracic surgery
|July 27, 2024
概括
感染性内心炎的早期门手术在急性中风患者中是可行的. 这种方法不会增加术后中风的风险,提供了及时干预的安全选择.
科学领域:
- 心脏病学 心脏病学
- 神经外科 神经外科
- 传染性疾病 传染性疾病
背景情况:
- 活动性传染性内心炎经常导致急性中风.
- 随着门的修复/更换,出血转换的风险会增加.
- 手术干预的最佳时间仍在争论中.
研究的目的:
- 评估早期门手术在患有活性传染性内心炎和急性中风的患者的安全性和结果.
- 评估手术前中风对术后中风发病率和出血转变的影响.
- 为了确定早期手术 (≤72小时) 是否会影响中风风险.
主要方法:
- 一个机构的胸部外科医生协会数据库 (2016-2024) 的回顾性审查.
- 分析电子医疗记录以了解中风细节和后续情况.
- 描述性统计和Kaplan-Meier生存曲线用于结果评估.
主要成果:
- 656名患者因活跃内心炎接受了门手术.
- 14.9%的患者经历了手术前的中风;18.6%的患者有微出血,12.2%的患者有出血性中风.
- 手术后中风发生率总体为2.1%,手术前中风或没有中风的患者之间没有显著差异 (4.1%对1.8%).
- 在手术前中风组中,术后出血性中风的比例较高 (3.1%与0.5%相比).
- 在手术前中风患者的早期手术 (≤72小时) 与中风风险增加没有关联 (2.6%对5.0%).
结论:
- 当代数据支持急性内心炎与急性中风的早期门手术.
- 这一策略表明,术后中风风险非较低.
- 早期干预是一个可行的选择,挑战了以前对操作时间的担忧.
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